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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
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Is Elective Interval Appendicectomy after Successful Initial Conservative Management of Appendicular Mass Necessary?
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Background The traditional management of appendicular mass is an initial conservative treatment followed by interval appendectomy. Recently interval appendicectomy has been questioned.
Objective: The purpose of this study was to clarify the need and the role of interval appendicectomy after successful initial conservative treatment.
Method: This is a prospective study conducted in a major hospital in Basra from April 2006 to Septemper2010, included 65 patients with appendicular mass which subsequently proved postinflammmatory (phlegmonous) changes of the appendix were treated conservatively.
Results: Routine interval appendicectomy was not performed and needed after successful treatment in the majority of the patients (84.6%). F

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Publication Date
Thu Dec 01 2022
Journal Name
Environmental Nanotechnology, Monitoring & Management
Boosted visible-light-driven photocatalytic degradation of lomefloxacin over α-Ag2WO4/NiSx nanocomposites
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Sun Oct 01 2017
Journal Name
Journal Of Mechanical Science And Technology
Optimization of a rectangular pin fin using elliptical perforations with different inclination angles
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Publication Date
Wed Jul 04 2018
Journal Name
Civil Engineering Journal
Finite Element Analysis of Concrete Beam under Flexural Stresses Using Meso-Scale Model
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Publication Date
Wed Jan 01 2025
Journal Name
Aip Conference Proceedings
Comparative analysis of parameter estimation methods for Meixner process using wavelet packet transform
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The current research creates an overall relative analysis concerning the estimation of Meixner process parameters via the wavelet packet transform. Of noteworthy presentation relevance, it compares the moment method and the wavelet packet estimator for the four parameters of the Meixner process. In this paper, the research focuses on finding the best threshold value using the square root log and modified square root log methods with the wavelet packets in the presence of noise to enhance the efficiency and effectiveness of the denoising process for the financial asset market signal. In this regard, a simulation study compares the performance of moment estimation and wavelet packets for different sample sizes. The results show that wavelet p

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Sun Dec 01 2002
Journal Name
Iraqi Journal Of Physics
A Hyperbolic Potential Field Model for Designing an Einzel Lens of Low Aberrations
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An analytical model in the form of a hyperbolic function has been suggested for the axial potential distribution of an electrostatic einzel lens. With the aid of this hyperbolic model the relative optical parameters have been computed and investigated in detail as a function of the electrodes voltage ratio for various trajectories of an accelerated charged-particles beam. The electrodes voltage ratio covered a wide range where the lens may be operated at accelerating and decelerating modes. The results have shown that the proposed hyperbolic field has the advantages of producing low aberrations under various magnification conditions and operational modes. The electrodes profile and their three-dimensional diagram have been determined whi

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Publication Date
Thu Nov 30 2017
Journal Name
Journal Of Engineering
Hydrodesulfurization of Iraqi Atmospheric Gasoil by Ti-Ni-Mo/γ-Al2O3 Prepared Catalyst
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This study investigates the improvement of Iraqi atmospheric gas oil characteristics which contains 1.402 wt. % sulfur content and 16.88 wt. % aromatic content supplied from Al-Dura Refinery by using hydrodesulfurization (HDS) process using Ti-Ni-Mo/γ-Al2O3 prepared catalyst in order to achieve low sulfur and aromatic saturation gas oil. Hydrodearomatization (HDA) occurs simultaneously with hydrodesulfurization (HDS) process. The effect of titanium on the conventional catalyst Ni-Mo/γ-Al2O3 was investigated by physical adsorption and catalytic activity test. Ti-Ni-Mo/γ-Al2O3 catalyst was prepared under vacuum impregnation condition to ensure efficient precipitation of metals within the carrier γ-Al2O3. The loading percentage of met

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Publication Date
Mon Oct 03 2016
Journal Name
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Development of Excess Pore Water Pressure around Piles Excited by Pure Vertical Vibration
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Fri Mar 01 2019
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Experimental Study of Forced- Convection from Horizontal Rectangular Fins Array into Air Duct
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    In this work, an experimental study has been done to expect the heat characteristics and performance of the forced-convection from a heated horizontal rectangular fins array to air inside a rectangular cross-section duct. Three several configurations of rectangular fins array have been employed. One configuration without notches and perforations (solid) and two configurations with combination of rectangular-notches and circular-perforations for two various area removal percentages from fins namely 18% notches-9% perforations and 9% notches-18% perforations are utilized.  The rectangular fins dimensions and fins number are kept constant. The fins array is heated electrically from the base

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Publication Date
Fri Apr 01 2011
Journal Name
Chinese Chemical Letters
Extraction of cobalt(II) from aqueous solution by N,N′-carbonyl difatty amides
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