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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
Sat Sep 30 2023
Journal Name
Tikrit Journal Of Administrative And Economic Sciences
The impact of Outward bank transfers on exchange rates in Iraq
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The depreciation of the Iraqi dinar against the US dollar, reaching low levels and causing disruptions in the local markets, has had detrimental effects on individuals and companies, particularly those with limited income and the poor. The local currency approached around 1600 dinars per dollar, after the official exchange rate had stabilized at around 1450 dinars per US dollar. This depreciation in the value of the Iraqi dinar can be attributed to financial speculation among currency traders, which directly affected exchange rates and illicit dollar smuggling operations. Bank transfers are also important alongside financial transactions, especially in light of current economic developments in the 21st century. To prevent currency s

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Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effect of Atenolol on CK-MB Levels in Hypertensive Patients
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Atenolol is one of beta-adrenergic receptor blocking agent. It is widely used for the treatment of hypertension as a selective antihypertensive drug. But long term usage of atenolol may cause one of the cardiovascular diseases like myocardial infarction. To prove the relationship between atenolol and cardiovascular disease, measurement of creatinekinase-MB as a diagnostic indicator in early and long term usage of this drug by hypertensive patients is recommended.  A comparative study was conducted in Al-Yarmouk Teaching Hospital–Emergency Department- on 30 hypertensive patients using atenolol. They were divided into (2) groups A and B according to the duration of the drug usage. Group A- (15) patients with a mean age (56

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Sun Dec 01 2024
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The impact of methamphetamine on liver injury in Iraqi male addicts
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Publication Date
Mon Aug 01 2016
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Vehicular ad hoc network (VANET) is a distinctive form of Mobile Ad hoc Network (MANET) that has attracted increasing research attention recently. The purpose of this study is to comprehensively investigate the elements constituting a VANET system and to address several challenges that have to be overcome to enable a reliable wireless communications within a vehicular environment. Furthermore, the study undertakes a survey of the taxonomy of existing VANET routing protocols, with particular emphasis on the strengths and limitations of these protocols in order to help solve VANET routing issues. Moreover, as mobile users demand constant network access regardless of their location, this study seeks to evaluate various mobility models for vehi

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Fri May 01 2020
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Pilgrims tracking and monitoring based on IoT
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Publication Date
Wed May 17 2023
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College Of Islamic Sciences
Sharia's position on historical statues and monuments
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A disagreement has arisen among scholars regarding the ruling on historical statues and monuments in Muslim countries, especially after the Taliban blew up some huge historical statues, and we have witnessed different positions that reach the point of contradiction, each claiming to be right, and now that the crisis has passed and the intensity of the dispute has subsided, I see It is appropriate to discuss this issue calmly, without drifting behind this or that party, to find out the legal position on these statues and monuments.
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Wed Feb 20 2019
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Political Sciences Journal
Global tolerance and its impact on peace
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The concept of tolerance is gaining its importance in the midst of an international society suffering from violence, wars and internal and international crises. It is practiced by extremist and extremist forces and movements acting in the name of religion to exclude the different Muslim and non-Muslim people according to the unethical practices and methodologies of Islamic law and reality. , Cultural, civilization .. that distinguish our world today. The society today is suffering from the ideas of the intellectual and aesthetic views of the different ideologically, ethnically, culturally and religiously in the world of the South. This is what the end-of-history thesis of Fukuyama and the clash of civilizations represented to Huntington.

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