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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 Jan 01 2024
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Fri Feb 20 2026
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In vivo immunohistochemical investigation of the effect of the topical application of growth hormone on the osseointegration of cpTi implant
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Publication Date
Fri Feb 20 2026
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The impact of the use of mirrors in the level of performance of some skills epeeEmpirical researchStudents on the third stage in the Faculty of Physical Education for Girls
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Wed Jan 01 2020
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Bayesian and non-Bayesian estimation of the lomax model based on upper record values under weighted LINEX loss function
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In this article, we developed a new loss function, as the simplification of linear exponential loss function (LINEX) by weighting LINEX function. We derive a scale parameter, reliability and the hazard functions in accordance with upper record values of the Lomax distribution (LD). To study a small sample behavior performance of the proposed loss function using a Monte Carlo simulation, we make a comparison among maximum likelihood estimator, Bayesian estimator by means of LINEX loss function and Bayesian estimator using square error loss (SE) function. The consequences have shown that a modified method is the finest for valuing a scale parameter, reliability and hazard functions.

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Scopus (9)
Scopus
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