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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
Fri Jun 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Oral Health Status among 9 years old school Children in Al-Diwaniyah City/Iraq.
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Background: Although they are not life threatening, dental caries and periodontal disease are the most predominant and widely spread oral diseases throughout the world. Another most common dental problem seen in children is dental trauma. The aims of the study included the investigation of the prevalence and severity of dental caries, gingivitis and dental plaque in relation to gender, furthermore, the prevalence and severity of the traumatized anterior teeth were assessed. Materials and Methods: This oral health survey was conducted among primary school children aged 9 years old in Al-Diwaniyah city in Iraq. The total sample composed of 600 child (320 males and 280 females) selected randomly from different school in Al-Diwaniyah city. Dia

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Wed Jan 01 2020
Journal Name
Euromediterranean Biomedical Journal
ESCHERICHIA COLI O157: H7 INVESTIGATION IN CHILDREN WITH DIARRHEA: AN IRAQI CROSS-SECTIONAL STUDY
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Scopus
Publication Date
Thu Mar 30 2017
Journal Name
Journal Of Biotechnology Research Center
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Thu May 18 2023
Journal Name
College Of Islamic Sciences
The battle of Dumat al-Jandal And its impact on the era of prophecy And the righteous caliphate
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Publication Date
Fri Oct 30 2020
Journal Name
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The effect of some short-term debt instruments on the money supply and its effect on the production of wheat crop in Iraq during the period (1990_2018).
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Publication Date
Sun Aug 30 2020
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Publication Date
Wed Aug 17 2022
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The effect of using Gaussian, Kurtosis and LogCosh as kernels in ICA on the satellite classification accuracy
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