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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
Sun Jul 01 2001
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIELD EFFICACY OF THREE TYPES OF INSECTICIDES AGAINST LARVAE OF MUSCADOMESTICABREEDING IN EQUINE MANURE AND THEIR EFFECTS ON PREDATORY MITES
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The field efficacy of Actellic (organophosphate), Neporex (insect growth regulator) and
Ficam (carbamate), at the application rates of 2-4, 0.4-0.8 and 0.1-0.2 g AI/m2 respectively,
was studied against the larvae of Musca domestica L. Results of treatments involving horse
manure indicated that Actellic and Neporex produced sharp decrease of larval numbers (close
to zero) for 21d. But there was a slight recovery in larval numbers 14 d following treatment
with Ficam. The populations of predator mites were not affected due to insecticidal
applications.

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
Performance Appraisal and its impact on behavioral and Attitudinal work outcomes Analytical research of the views of a sample of teaching staff at Colleges of the University of Fallujah
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Publication Date
Tue Aug 08 2023
Journal Name
مجلة حمورابي للدراسات
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Wed Aug 30 2023
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Wed Jul 24 2024
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Thu Apr 04 2024
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Publication Date
Fri Jan 08 2010
Journal Name
Al-kindy College Medical Journal
Maternal and fetal outcomes in emergency versus elective two or more previous cesarean deliveries
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Publication Date
Wed Jun 30 2010
Journal Name
Al-kindy College Medical Journal
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caesarean deliveries
Design: Randomized prospective clinical
study
Setting: Al-Elweya Maternity Teaching
Hospital, from 1st of March to 31st of
September 2008.
Methods: The study groups, those who had
previous two or more caesarean deliveries,
were included from the hospital admissions.
The 1st group (102 women) presented in labor
and was managed by caesarean delivery as
soon as it was possible. The second group (7

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Publication Date
Sun Apr 30 2023
Journal Name
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