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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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Fri Jan 15 2021
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Sun Jan 27 2019
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        Accompanied Activity Economic Unity some negative effects in the environment of air, water and soil pollution of difficult to measure each other for being the external costs and to be avoided such expenditures should be measured or estimated value to be disclosed environmental costs at the heart of the financial statements of economic unity to inform managers and users of the financial statements on the implications costs environmental .and impact in reducing environmental costs and increase future income and economic unit, was based on research into the inductive approach through books, letters, journals and the internet to cover the theoretical framework of the research. And to the analyt

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Mon Jun 30 2008
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Iraqi Journal Of Chemical And Petroleum Engineering
The Effect of Ageing on Physical and Chemical Properties of Asphalt Cement
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Two grades of paving asphalt with penetration of 46 and 65 are studied for determining changes in their physical and chemical properties caused by ageing.
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Thu Aug 01 2019
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Tue Aug 03 2021
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The impact of the procedures of the Banking Compliance Controller on the decision to grant credit and default: Applied research in a sample of Iraqi banks
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Wed Feb 20 2019
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Article The problem of nuclear proliferation and its impact on the formula of strategic balance in the Middle East after the events of September 11, 2001
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The issue of nuclear proliferation is one of the most vital issues as it reflects a form of dealing in the field of international relations. Therefore, the Middle East region has taken great interest in reducing the levels of nuclear armament and acquiring nuclear power within the strategic framework of the international and regional powers. The establishment of a nuclear-weapon-free zone in the Middle East region is currently one of the most important international and regional arrangements for controlling the levels of nuclear proliferation and attempting to build a state of stability and balance. In the Middle East and the world. The importance of the research comes from the fact that it deals with an important and vital issue

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Thu Jun 01 2023
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Journal Of Engineering
On the Laser Micro Cutting: Experimentation and Mathematical Modeling based on RSM-CCD
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The laser micro-cutting process is the most widely commonly applied machining process which can be applied to practically all metallic and non-metallic materials. While this had challenges in cutting quality criteria such as geometrical precision, surface quality and numerous others. This article investigates the laser micro-cutting of PEEK composite material using nano-fiber laser, due to their significant importunity and efficiency of laser in various manufacturing processes. Design of experiential tool based on Response Surface Methodology (RSM)-Central Composite Design (CCD) used to generate the statistical model. This method was employed to analysis the influence of parameters including laser speed,

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Processed and red The Western diet, a modern dietary pattern, typically consists of meat, sugar-filled beverages, candies, chocolates, fried foods, prefabricated meals, refined cereals, conventionally produced animal products, high-fat dairy products, and high-fructose items. The goal of this review is to outline how the Western pattern diet affects gut microbiota and mitochondrial fitness, as well as metabolism, inflammation, and antioxidant status. Cancer, mental health, and cardiovascular health; We offer a thorough analysis of how the westernized diet and related nutrients affect immune cell responses as well as the hygienic costs of the Western diet. A consensus critical evaluation utilizing primary sources, including scientifi

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Wed Mar 15 2023
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The Egyptian-Chinese Consensus at the Bandung Conference and Its Impact on Strengthening Relations between Them in 1955
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Fri Feb 08 2019
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Problematic intervention in the new international order and its impact on international relations - the U.S. role a model
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