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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 Oct 18 2022
Journal Name
Arab World English Journal For Translation & Literary Studiesissn: 2550-1542 |www.awej-tls.org17awej For Translation & Literary Studies,
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This paper examines the decolonizing methods used by Leslie Marmon Silko in her novel Ceremony (1977) to heal the indigenous people from the patriarchal traditions of the white hegemony. This study aims to emphasize the vulnerable responses of the Pueblo people to the memories of the clan and to highlight Silko’s methods to sustain the history and lifestyle of the indigenous people. Therefore, Silko’s novel can be situated historically and culturally within memory-studies. To analyze the contrasting behaviors of characters, this paper projects the relationship between the collective patriarchal doctrines and that of the individual within the framework of memory studies. Theories of Jan and Aleida Assmann are used here to explore the

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Publication Date
Wed Oct 11 2023
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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the forensic accounting philosophy in the transparency and quality of financial statements: : An applied study on a sample of workers at the Trade bank of Iraq and the Gulf Commercial Bank in Babylon
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This research aims to identify the role that forensic accounting plays on the transparency and quality of the financial statements in trade bank of Iraq and the Gulf Commercial Bank in Babylon. This research came to address the problem that most financial institutions suffer from, which is represented by the lack of transparency and the quality of the financial statements issued in a manner. Annual also the manipulation and fraud in the financial data, which causes a big gap between that institutions and organizational stakeholders. According to the implementation of the research hypothesis and the objectives of the research, a questionnaire was prepared consisting of three axes, the first axis dealing with the demographic distri

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Publication Date
Fri Mar 30 2012
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Numerical Analysis of Laminar Natural Convection in Square Enclosure with and without Partitions and Study Effect of pPartition on the Flow Pattern and Heat Transfer
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Publication Date
Sun Dec 01 2019
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Histological and Physiological Studies on the Long-term Effect of Different Concentrations of Energy Drink (Tiger) on the Renal and Hepatic Systems of Young Mice
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The present study aims to investigate the long-term histopathological, and physiological effects of different concentrations of a commercially available energy drink (Tiger) on liver and kidney of young mice. Sixteen Balb/c male mice,6 -week old, were divided into 4 groups (n=4). Two groups consumed the energy drink at a concentration of 28µl energy drink/ml water. One group were killed after 10 days (T1), another group were killed after 20 days (T2). Other group of mice consumed the energy drink at a final concentration of 14µl/ml for 20 days (T3). The last group was provided only with water and served as control. Mice of all groups drank around 3 ml per day. The histopathological study on liver of treated groups showed many changes s

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Publication Date
Wed Jun 01 2022
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Terrorism and its impact on the right of Human in development - A study case of ISIS (Daesh) in Iraq
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Sun Jun 01 2014
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Effect Study the of Acute toxoplasmosis on Some Blood and Serum Parameters in Pregnant Women in Baghdad City
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Urban Geomorphology and Its Impact on Determining the Trends of Urban Expansion in The City of Kut and Its Future Expectations Using Geographic Information Systems
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