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Comparing the Efficacy of Paracetamol, Diclofenac, and Ketorolac on Post-Appendectomy Outcomes in Children and Adolescents
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Abstract

urgent surgical intervention and appendectomy until now represent standard treatment for uncomplicated cases of appendicitis. Nausea, vomiting and pain after surgery are the most frequent issues facing patients and affecting patient quality of life and responsible for many cases of readmission after surgery. Ketorolac and diclofenac represent the most commonly prescribed non-steroidal anti-inflammatory used in postoperative setting and they cause many side effects as gastrointestinal, kidney and cardiac adverse effect in addition to increased risk of bleeding. Paracetamol is currently among the most frequently prescribed medication worldwide and it can be used safely for all age groups. This study aimed to compare the analgesic efficacy and safety of paracetamol, diclofenac, and ketorolac when used after appendectomy and to assess their efficacy regarding nausea and vomiting in children and adolescents. A randomized, single-blinded, comparative, observational prospective clinical study was carried out on patients diagnosed with acute appendicitis and assigned for emergent appendectomy between October 2018 to May 2019 in Al- Zahraa Teaching Hospital in Al-Najaf province, Iraq.120 patients were randomly distributed into three groups who received diclofenac sodium suppositories (2mg/kg), IV Paracetamol )15mg/ kg every 6 hr.(, and IV  Ketorolac )0.5mg/ kg( immediately after surgery. All patients were observed for pain, nausea and vomiting and bleeding. Patients received ketorolac had a high percentage of the decrease in pain score between 30 and 60 min. after surgery, while paracetamol was the next and diclofenac sodium was the last. Regarding nausea and vomiting after surgery, ketorolac had higher percentage of the decrease in nausea, vomiting score during first day after surgery followed by diclofenac and paracetamol respectively. The present study also showed that there is no significant difference between groups regarding bleeding after surgery. It is concluded that ketorolac has higher analgesic efficacy compared with paracetamol and diclofenac with no risk of nausea and vomiting and bleeding when used after appendectomy.

Keywords: Postoperative pain, Ketorolac, Diclofenac, Paracetamol, Appendectomy.

 

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Prevalence of obesity among adolescents at secondary schools in Kirkuk city
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Objective: to identify the secondary school adolescent's obesity, and to find out the relationship between
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Results: the prevalence of obesity among adolescents was 22.3%. (55.8%) of the obese adolescents were male,
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There are a significant relationship between obese adolescents and their family history of obesity which indicated
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Wed Jan 01 2014
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Int. J. Adv. Res
Antibacterial activity of parsley and celery aqueous extract on the isolated bacteria from children UTI in Erbil city‏
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Wed Sep 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
The Efficacy of Polidocanol foam Sclerotherapy in Treatment of Infantile Hemangioma and Slow-Flow Vascular Malformation
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Background: Sclerotherapy is a simple treatment modality for treatment of infantile hemangioma and slow-flow vascular malformations; Polidocanol is a mild sclerosing agent that is traditionally used in treatment of varicose veins. This study aims to evaluate the effectiveness, treatment outcome, and complications of polidocanol foam sclerotherapy for infantile hemangioma and slow-flow vascular malformations. Materials and methods: Between March 2013 and December 2014, seventeen patients with infantile hemangioma and slow-flow vascular malformations treated with polidocanol 1% foam sclerotherapy. Foam was prepared by Tessari’s method. Injection performed under general or local anesthesia, injections were repeated (if necessary) on mon

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Effectiveness of Post-Abortion Family Planning Counseling Program on Nurses and Midwives' Practices in Middle Euphrates Maternity Hospitals
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Effect of Diclofenac (Voltaren) in histological structure of kidney in male Rabbits (Oryctolagus cuniculus )
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This study was designed to know the effect of Diclofenac sodium (voltaren) drug on the histological composition of kidney in domestic rabbits . Twelve adult males with (1.4) kg weight . The first group of animals administrated orally by 1 ml of Voltaren with 6 mg/kg , while the second group with (1) ml of distal water (as control group ) . the administrated continue for (60) days sequentially. The treatment with voltaren showed pathological cases in tissues and cells of kidney including necrosis, infilteration ,congestion in blood vessels edema.Also epithelial separation in kidney tubules in comparison with control group Conclusion from the above results, revealed that voltaren had negative effects on the kidn

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