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bijps-974
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
Sun Jul 12 2020
Journal Name
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The current research aims to identify the risk management and its impact on the quality of service in the Salahalddin Sewerage Directorate, This is due to the great impact that the service provided by this institution plays in preserving health and the environment in the community, which has faced many administrative challenges, problems and issues as a result of the rapid and continuous environmental changes, and therefore, the adoption of administrative concepts such as risk management and knowledge of their impact on the quality of the municipal service is necessary to reach this service To the required levels. To achieve the research objectives, two main hypotheses have been formulated, the first of which is to find the extent of the li

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Sun Jun 01 2008
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Subject Review: The Effectiveness Of Integrating E-Learning On Learning Outcome And Student Perceptions In Tertiary Education
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The literature shows conflicting outcomes, making it difficult to determine how e-learning affects the performance of students in higher education. The effect of e-learning was studied and data has been gathered with the utilization of a variety of qualitative and quantitative methods, especially in relation to students' academic achievements and perceptions in higher education, according to literature review that has been drawn from articles published in the past two decades (2000-2020). The development of a sense of community in the on-line environment has been identified to be one of the main difficulties in e-learning education across this whole review. In order to create an efficient online learning community, it could be claim

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Sun Jan 27 2019
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