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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
Thu Jul 30 2026
Journal Name
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The effect of in office bleaching on surface roughness and micro-hardness of newly developed composite materials (In vitro study)
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Publication Date
Wed Mar 28 2018
Journal Name
Indian Journal Of Natural Sciences
Detection of the Main Mycotoxins in Feed of Horses in Al-Zawra'a Park and Study their Effects on Hematological Feature
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Publication Date
Tue Jun 18 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
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Publication Date
Sun Jul 01 2018
Journal Name
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Publication Date
Fri Mar 28 2025
Journal Name
Journal Of Physical Education
Special exercises using tools and their effect on teaching the skill of a front shoulder circle on the rings apparatus in artistic gymnastics for students
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Thu Oct 31 2013
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The excellent specifications of electrodes coated with lead dioxide material make it of great importance in the industry. So it was suggested this study, which includes electrodeposition of lead dioxide on graphite substrate, knowing that the electrodeposition of lead dioxide on graphite studied earlier in different ways.

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Publication Date
Sat Sep 30 2023
Journal Name
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Thu Feb 01 2018
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