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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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Wed Jul 01 2020
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The Iraqi political and social arena has been characterized, subjectively and objectively, by the weakness of leadership building. This has led to a leadership crisis, which is reflected in the quality of the outcome of the process of rebuilding the state in Iraq. Thus, this building process has lacked the simplest requirements and conditions of success. It has suffered from a major and obvious failure: the situation in Iraq has raised conflict leaders, not constructive leaders, and this confirms the existence of a cultural crisis in the production of conscious, aware leadership compatible with democratic action. The weakness of leadership in Iraq is reflected in a series of ongoing crises that require radical solutions in accordance with l

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Fri Jun 30 2023
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Patients' Knowledge and adherence to Clopidogrel Therapy post Percutaneous Coronary Intervention
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Objectives: To assess patients’ knowledge and their adherence to Clopidogrel Therapy Post Percutaneous Coronary Intervention, and to find out the relationship between patients’ knowledge and their adherence to Clopidogrel Therapy Post Percutaneous Coronary Intervention

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Tue Jun 24 2025
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Prevalence of Prematurity Outcomes of Overweight Adolescent Pregnancy in One Thousand Premature Neonates in Baghdad
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Sat Jun 15 2019
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Impact of Brix 3000 and conventional restorative treatment on pain reaction during caries removal among group of children in Baghdad city
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Sun Dec 04 2011
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Effect of Laser Irradiation on the Optical Properties of SnO2 films Deposited by Post Oxidation of metal Films
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Tin oxide films (SnO2) of thickness (1 ?m) are prepared on glass substrate by post oxidation of metal films technique. Films were irradiated with Nd:YAG double frequency laser of wavelength (532 nm) pulses of three energies (100, 500, 1000) mJ. The optical absorption, transmission, reflectance, refractive index and optical conductivity of these films are investigated in the UV-Vis region (200-900) nm. It was found that the average transmittance of the films is around (80%) at wavelength (550 nm) and showed high transmission (? 90 %) in the visible and near infrared region. The absorption edge shifts towards higher energies, which is due to the Moss-Burstien effect and it lies at (4 eV). The optical band gap increased with increasing of ene

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