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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
Mon Dec 30 2024
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
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The current study examines the combined impacts of ultrasonic waves and nano silica (NS) on reducing the viscosity Sharqy Baghdad heavy crude oil with an API gravity of 20.32. NS of an average particle size of 59.93 nm and 563.23 m²/g surface area were produced utilizing the sol-gel technique from Iraqi sand. The XRD analysis indicates the existence of an amorphous silica, the SEM analysis showed that NS tends to agglomerate, and the FTIR spectra exhibited the presence of siloxane and silanol groups. In addition, the TGA analysis demonstrated a total weight loss of 15.62%, validating the thermal stability of the NS. The experiments included a study of the impact of ultrasonic power, exposure time, duty cycle, temperature, and the c

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Sat Apr 01 2017
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Tacit knowledge of auditors and their reflection on the effectiveness of the performance to some inspectors general offices
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Publication Date
Tue Dec 01 2020
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Leverage and its impact on the profitability of Islamic banks in Iraq: Case Study: Islamic Cooperation Bank for Investment for the years (2015-2018)
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Publication Date
Sat Jan 01 2022
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