The Impact of IV Acetaminophen on Pain After Appendectomy for Perforated Appendicitis
The Impact of IV Acetaminophen on Pain After Appendectomy for Perforated Appendicitis
The objective of this study is to evaluate two standard post-operative pain regimens
 routinely used after laparoscopic appendectomy for perforated appendicitis. The investigators
 hypothesize that the use of intravenous (IV) acetaminophen in addition to IV ketorolac with
 narcotic pain pump will decrease time to transition off patient/nurse controlled analgesia
 (PCA) to oral pain medications.
To assess pain control, patient and family perception of pain control, time to return of
 bowel function defined as passage of first flatus (in days), doses of anti-emetic
 medications, doses of narcotic pain medications, time to toleration of regular diet (in
 days), narcotic associated adverse effects (nausea, emesis, respiratory depression,
 constipation), length of stay, and overall hospital cost in admission.

 Post-hospitalization the investigators will assess complications including number and reasons
 for emergency visits and abscess formation, length of post-hospitalization analgesic use,
 length of post-hospitalization narcotic use, and time to return to school.
Inclusion Criteria:

 -  All patients ages 2-17 years old undergoing laparoscopic appendectomy at CMH found to
 have perforated appendicitis.

 Exclusion Criteria:

 -  Non-perforated appendicitis

 -  Normal appendix at the time of operation or other associated conditions causing
 abdominal pain

 -  Patients with history of chronic pain

 -  Known underlying liver disorders

 -  Known allergy to pain medication in protocol

 -  Non-English speaking