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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
Wed Feb 17 2016
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Wed Nov 04 2020
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Speech intelligibility: a study of Iraqi EFL learners’ accented English
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Fri Mar 01 2019
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Oxidation of sulfur compounds in fuel followed by an adsorption process were studied using two modes of operation, batch mode and continuous mode (fixed bed). In batch experiment oxidation process of kerosene with sulfur content 2360 ppm was achieved to study the effect of amount of hydrogen peroxide(2.5, 4, 6 and 10) ml at different temperature(40, 60 and 70)°C. Also the effect of amount acetic acid was studied  at the optimal conditions of the oxidation step(4ml H2O2 and 60 °C).Besides, the role of acetic acid different temperatures(40, 60, 70) °C and 4ml H2O2, effect of reaction time(5, 30, 60, 120, 300) minutes at temperatures(40,60) °C, 4ml H2O2 and 1 mlHAC)&

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This paper presents on the design of L-Band Multiwavelength laser for Hybrid Time Division Multiplexing/ Wavelength Division Multiplexing (TDM/WDM) Passive Optical Network (PON) application. In this design, an L-band Mulltiwavelength Laser is designed as the downstream signals for TDM/WDM PON. The downstream signals ranging from 1569.865 nm to 1581.973 nm with 100GHz spacing. The multiwavelength laser is designed using OptiSystem software and it is integrated into a TDM/WDM PON that is also designed using OptiSystem simulation software. By adapting multiwavelength fiber laser into a TDM/WDM network, a simple and low-cost downstream signal is proposed. From the simulation design, it is found that the proposed design is suitable to be used

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