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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 Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Using Brainstorming Technique on the Essay Writing and Self- regulation Learning of the Iraqi Secondary Students
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         This study investigated the effect of using brainstorming as a teaching technique on the students’ performance in writing different kinds of essays and self regulation among the secondary students. The total population of this study, consisted of (51) female students of the 5th Secondary grade in Al –kawarzmi School in Erbil during the academic year 2015-2016. The chosen sample consisted of 40 female students, has been divided into two groups. Each one consists of (20) students to represent the experimental group and the control one. Brainstorming technique is used to teach the experimental group, and the conventional method is used to teach the control group. The study inst

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Adultery in the Ancient near east from the standpoint of the customs and traditions and the old laws
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Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
The Role Of Intellectual Capital In The Performance Of Small And Medium Enterprises Research filed In Small And Medium Enterprises In Baghdad
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Wed Jan 01 2020
Journal Name
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The effect of adding some organic and mineral substances to calcareous soil on adsorption and desorption of copper and its removal efficiency from soil
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Bifurcation analysis of the role of good and bad bacteria in the decomposing toxins in the intestine with the impact of antibiotic and probiotics supplement
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This study presents a mathematical model describing the interaction of gut bacteria in the participation of probiotics and antibiotics, assuming that some good bacteria become harmful through mutations due to antibiotic exposure. The qualitative analysis exposes twelve equilibrium points, such as a good-bacteria equilibrium, a bad-bacteria equilibrium, and a coexisting endemic equilibrium in which both bacteria exist while being exposed to antibiotics. The theory of the Sotomayor theorem is applied to study the local bifurcation around all possible equilibrium points. It’s noticed that the transcritical and saddle-node bifurcation could occur near some of the system’s equilibrium points, while pitchfork bifurcation cannot be accrued at

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Wed Dec 30 2015
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Publication Date
Wed Jul 27 2022
Journal Name
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Exercises Of Varying Resistances And Muscular Work Exchange Effects On Physical Adequacy And The Completion Of 200m - Meter Freestyle Swimming
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Tue Dec 15 2020
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Publication Date
Fri Jan 03 2020
Journal Name
Chalcogenide Letters
THE EFFECT OF Ag CONTENT AND HEAT TREATMENT ON STRUCTURAL AND MORPHOLOGICAL PROPERTIES OF THIN (Cu1-xAgx)2 ZnSnSe4 FILMS
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(Cu1-x,Agx)2ZnSnSe4 alloys have been fabricated with different Ag content(x=0, 0.1, and 0.2) successfully from their elements. Thin films of these alloys have been deposited on coring glass substrate at room temperature by thermal evaporation technique under vacuum of 10-5Torr with thickness of 800nm and deposition rate of 0.53 nm/sec. Later, films have been annealed in vacuum at (373, and 473)K, for one hour. The crystal structure of fabricated alloys and as deposited thin films had been examined by XRD analysis, which confirms the formation of tetragonal phase in [112] direction, and no secondary phases are founded. The shifting of main polycrystalline peak (112) to lower Bragg’s angle as compared to Cu2ZnSnSe4 angle refers to incorpora

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Publication Date
Fri Mar 01 2019
Journal Name
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