Enhanced Recovery After Surgery (ERAS) for Complicated Appendicitis

Inclusion criteria

• Individuals between the ages of 18 and 65 years of age.
• Patients undergoing a laparoscopic appendectomy.
• Diagnosis of complicated appendicitis based on pre-operative imaging or intra-operative assessment. The definition of a complicated appendicitis will include: (a) perforated appendicitis, without generalized peritonitis; (b) gangrenous appendicitis, without generalized peritonitis; (c) suppurative appendicitis; (d) iatrogenic perforation of the appendix.
• Meet criteria for discharge from the post-anesthesia care unit (PACU).
• Ability to reliably follow up with the study procedures.

Exclusion criteria

• Age < 18 years or > 65 years.
• Pregnancy.
• Homelessness.
• Patients who present with generalized peritonitis.
• Patients with comorbid conditions, including diabetes mellitus, immunosuppressed state for any reason, patients on chronic anticoagulation (excluding Aspirin 81 mg).
• Patients who present with septic shock.
• Patients who require conversion to an open appendectomy.
• Patients who present with additional findings on imaging studies or intra-operatively, including ileus or small bowel obstruction.
• Based on surgeon's clinical judgment for reasons that may not be outlined above.
• Allergy or intolerance to study medication(s)