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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
Wed Mar 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Internal Debt Options during the Two Double Shocks and Its Impact on Foreign Reserve in Iraq
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Mon Apr 01 2013
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STUDY THE COMPARATIVE EFFECT BETWEEN CYPERUS ESCULENTUS SEEDS EXTRACT AND GENTAMICIN ON INDUCED ENDOMETRITIS IN MICE
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Mon Feb 14 2022
Journal Name
Journal Of Educational And Psychological Researches
Comparative between Intermediat Stage Art Education Curriculum in Iraq and Egypt Base on the Contemporary Theory
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Publication Date
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Field study of the effect of jet grouting parameters on strength based on tensile and unconfined compressive strength
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Abstract<p>The improvement of the mechanical soil characteristics of jet grouting technique is very attractive. The jet grouted soil cement columns in soft is a complicated issue because it depends on a number of factors such as, soil nature, mixture, influence among soil and grouting materials, jetting force of nozzle, jet grouting and water flow rate, rotation and lifting speed. This paper discusses the estimation of shear strength parameters of soil-cement column (soilcrete) in soft clayey soil based on the relationships between the unconfined compressive and split tensile strength for the soilcrete and the effect of the jet grouting and water pressure in the values of cohesion and internal f</p> ... Show More
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Tue Dec 11 2018
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Sun Apr 14 2024
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