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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
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
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The research seeks to highlight the importance of digital finance in banking by providing financial and banking services and its role in improving the access of financial services to customers at the farthest possible point by using modern technology to finance their needs by granting them cash credits through electronic payment tools to facilitate them and shorten time and effort as well as Low cost, and this cannot be achieved without concerted efforts and the provision of basic infrastructure that includes connecting the Internet to all targeted areas, whether cities or rural areas, as well as distributing the largest possible number of ATMs and sending specialized teams to those areas that develop in customers the culture of digital

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Thu May 05 2022
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Al-kindy College Medical Journal
The Anxiety and Fear of COVID-19 Pandemic at the First Year in Dentists Working in Specialist Dental Centers
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Sun Jun 30 2013
Journal Name
College Of Islamic Sciences
The Leader: His Qualifications and Attributes in the Quranic Perspective in Light of Surat Al-Naml - An Objective Study
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Thu Oct 01 2015
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Mon Dec 01 2014
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Sat Jul 20 2019
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Prevalence of Montelukast Use as an Add-On Therapy among Iraqi Asthmatics on Treatment Attending Al-Kindy Teaching Hospital and Al-Zahraa Center of Asthma and Allergy
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Sat Jul 20 2019
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Prevalence of Montelukast Use as an Add-On Therapy among Iraqi Asthmatics on Treatment Attending Al-Kindy Teaching Hospital and Al-Zahraa Center of Asthma and Allergy
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BACKGROUND: Montelukast (Singulair) is a cysteinyl leukotriene receptor antagonist, used for the maintenance treatment of asthma and to relieve symptoms of seasonal allergic rhinitis and asthma, also used for exercise-induced bronchospasm. AIM: This study was performed to determine the prevalence of Montelukast use as an add-on therapy among Iraqi asthmatic patients on treatment. Comparing the effectiveness of regimens with and without montelukast. METHODS: This descriptive cross-sectional study was carried out on 73 Iraqi asthmatic patients on treatment of both sexes with age range (18-60) years old, attending Al-Kindy Teaching Hospital and Al-Zahraa Centre of Asthma and Allergy, Baghdad, for the period between February

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Mon Dec 31 2018
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This study includes applying chemical tests on cow, sheep and chicken bones including both hallow and flat. The results of chemical tests on bones mentioned the moisture percentage which was between 4.95-7.32 %, and it was noticed the difference in protein percentage among different kinds of bones, The highest protien percentage was 39.62 % in hallow chicken bones and the lowest was in hallow sheep bones 20.31%, at the same time, the highest Ash percentage was in hallow sheep bones48.11% , whereas the highest percentage of fat was in hallow cow bones 30%. The chemical and physical tests were conducted for extracted fat from hallow and flat bones for cows, sheeps and chicken. It was found that peroxide values (PV), and free fatty acids (F

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Fri Jun 30 2023
Journal Name
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The Effect of the Needham model in teaching chemistry on interactive thinking among fifth-grade scientific students in Iraq
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Thu Aug 31 2023
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The role of breath holding technique on minimizing cardiac dose in left breast cancer irradiation in the adjuvant setting
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