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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 20 2019
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Political Sciences Journal
The Democracy and the Reconstruction of the Citizenship
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This research includes the principles of the democracy، and to which extent it can contribute in establishing these principles. Democracy is not only to hold parliamentary or presidential elections but also the result of these elections wills it lead to the emergence of an integrated regime that can actually expresses the citizen's rights and to which extent those citizens can contribute in that regime and control it. Since 2005، when the first elections took place in Iraq after the US occupation of Iraq 2003، Iraqi people are looking to a rule that represented them and achieve their interests after getting rid of the totalitarian regimes and establishing an institutional regime that work by democratic means in order to achieve the so

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Sun Mar 05 2017
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Tue Apr 04 2023
Journal Name
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An Empirical Study to Measure the Impact of Information Technology Governance Under the Control Objectives for Information and Related Technologies on Financial Performance
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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
Scientific miracle in the verse walking and eating In Surat Al - Mulk
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Wed Oct 18 2023
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Assessing the Nursing Knowledge and Practices in Premature Feeding in Premature Units
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Sun Dec 10 2017
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Wed Jan 01 2014
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