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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 Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Leadership Skills and their Impact on Strategic Planning: Applied Research in the Iraqi Ministry of Planning
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Publication Date
Wed Jan 01 2020
Journal Name
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Publication Date
Fri Sep 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluating the effect of natural, industrial juices and beverage on orthodontic bonding composite (in-vitro study)
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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Al-nahrain University
Histopathological Studies of the Liver and Kidney in Mice Fed on Smut Wheat Infected with Tilletia
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Fri Sep 15 2023
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Focus groups strategy and its impact on the achievement of primary school students in art education
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Tue May 16 2023
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Peaceful coexistence between social components and its impact on political stability in the province of Nineveh
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Publication Date
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Mon Dec 01 2014
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Publication Date
Sun Dec 31 2023
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
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Sun Oct 31 2021
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Stratigraphy and Nannofossil Biozonation of Sarmord Formation on the Qaywan Anticline in Sulaymaniyah Governorate, Northern Iraq
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The Sarmord Formation is one of the overlooked formations that require more investigations than that achieved before. There are many problems in its definition, age, stratigraphy and aerial distribution. Previously in most parts of the Sulaymaniyah, it is not mapped and its outcrops combined with Balambo Formation while in the present study it is differentiated, mapped in the field on the Qaywan anticline and its problems discussed in details with a suggestion of solutions. For laboratory studies, 31 samples are taken on the Qywan Mountain (anticline) at 23 km north of the Sulaimani city for nannofossils biozonation. This study identified 19 species of the recorded calcareous nannofossils, the studied section reveals three biozones

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