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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 Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Fine motor skills of kindergarten children
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Tue Jun 15 2021
Journal Name
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Forms of post-modernism in performance of Iraqi theatre "dream of Baghdad exam": عمار عبد سلمان محمد
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  The effects of postmodernism on theatrical form was managed by the director (Anas Abdul Samad) to be employed in the Iraqi play (Dream in Baghdad) and the researcher sought to study this problem and divided it into four chapters dealt with in the first chapter the problem of research and its need, the importance of research, As well as the definition of terminology, either Chapter II theoretical framework divided by the researcher to the first two is the postmodernism in the theater is the most prominent reference references and the second most important postmodern applications in the world play and then the researcher concluded the second chapter of the most important indicators. In the third chapter, the researcher identified th

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Fri May 01 2015
Journal Name
Journal Of The Faculty Of Medicine
Gentamycin injection in disc space during lumbar discectomy (aiming to prevent post - operative discitis)
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Tue Jan 01 2019
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Fri Oct 01 2021
Journal Name
Journal Of Al-rafidain University College For Sciences ( Print Issn: 1681-6870 ,online Issn: 2790-2293 )
Nutritional Status of Children below Five Years in Iraq for 2018
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Wed Sep 30 2020
Journal Name
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Study of Humoral Immune Response In Children Infected With Visceral Leishmaniasis
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Mon Mar 15 2021
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Publication Date
Thu Oct 01 2015
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Installing Quality of Gratitude in Children from an Islamic Educational Perspective
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The study aimed to identify how to raise grateful children from an Islamic educational perspective. For that objective to be achieved, the researcher used both of deductive and descriptive approaches using the method of documentary research. The study's results show that children are the real wealth of the community and the foundation of cultural building; therefore, paying attention their raising is a responsibility that must be shared by everyone; gratitude is part parcel of the Islamic doctrine, which is one of the greatest virtues; the virtue of gratitude is the attitude of the believers which in turn strengthens the bonds and expands the network of positive social relationships; It is also considered a cultural significance

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Publication Date
Fri Jun 20 1930
Journal Name
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