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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 Jan 01 2019
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Teaching-learning design according to constructivist theory models and its impact on the achievement of chemistry among second-year intermediate school female students
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Sun Mar 01 2009
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Baghdad Science Journal
MORPHOLOGICAL STUDIES ON THE EFFECT OFNIGELLA SATIVA SEEDS ON THE MAMMARY GLAND OF MATURE MALE NORWAY RAT
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Nigella sativa seeds (NSS) are reputed traditionally and scientifically as a potent agent that promote milk secretion (galactagogue), but their mechanism of action is studied trivially. One suggestion was that these seeds are bio-transformed to sex hormones within the ovaries. Therefore, this investigation was designated to throw light on the action of these seeds in the absence of ovaries i.e. in male rats. Thirty Norway male albino rats were used in this investigation. They were divided into experimental (n=20,fed NSS 2g/ Kg body weight /day for 14 days) and control (n=10, fed placebo for 14 days). After sacrifice mammary gland and blood samples were obtained. Experimental rats revealed a significant increase (p (0.01>in

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Publication Date
Sun Jan 01 2017
Journal Name
Journal Of The College Of Languages (jcl)
השואה והשלכותיה על אהרון אפלפלד - עיון בשלושה סיפורים קצרים עוזר למורה – עלי מוחמד רשיד The Holocaust and its impact on Aharon Bielefeld - A Study in Three Short Stories
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Publication Date
Wed Sep 08 2021
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Journal Of Accounting And Financial Studies ( Jafs )
The effect of financial leverage on the market value of the shares of Iraqi commercial banks: An applied research in the Bank of Baghdad for the period (2010-2019)
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Tue Sep 01 2020
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Thu Dec 20 2007
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The impact of decentralization on regional development
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As regional development, as a matter of course, poses a number of systemic, scientific and political problems. While the issue of development is primarily at the national level to the limits of World War II in the industrialized world and to the 1960s borders in most Third World countries, the increasing awareness of regional disparities has led to the regional issue Were taken into consideration in the early 1960s and 1970s in most industrialized and developing countries alike. The local issue was only introduced in the early 1980s. The awareness of regional disparities and the fact that the regions do not have the same potential and that some regions have the resources to enable them to develop, grow and develop, unlike other r

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Wed Mar 06 2002
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The role of the international auditing standard IAS 540 "Auditing accounting estimates and related disclosures" in limiting income smoothing practices in the financial statements (from the point of view of Iraqi auditors)
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                The current research aims to show the impact of the international auditing standard IAS 540 in reducing income smoothing practices in Iraq. To achieve the objectives of the research, the researcher adopted a questionnaire for a sample of auditors in Iraq. Where 60 forms were distributed and after the questionnaire was retrieved and statistical analysis was done using the SPSS program, The research reached a number of results, the most important of which are: the existence of a statistically significant effect of the application of the international auditing standard IAS 540 in reducing income smoothing practices, The research recommended the necess

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