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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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Mon Dec 01 2014
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Mon May 17 2021
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The Relative Contribution of the Flexibility for the Hip Joint, the Angle of the Knees, and the Muscular Strength for Arms of Performance of the Front and Back Rolling Skills, Opening on the Floor Movement Mat
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In order to improve the students’ performance level in some of the skills that are implemented on the mat device of ground movements, including the front and rear rolling, it is necessary to study the most important indicators that have a clear impact on the performance of those rolls. Among the objectives of the research: To identify the percentage of the contribution of flexibility of the hip joint, the angle of the knees and the muscular strength of the arms in the performance of the front and rear rolling skills, an opening of the research sample. The researchers used the descriptive method in the survey method for its suitability to the nature of the work, and the research community was represented by students of the third st

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Tue Jun 30 2020
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Mon Apr 19 2021
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The Impact Of Innovative Matrix Strategy And The Problem Tree Strategy On The Mathematical Proficiency Of Intermediate Grade Female Students
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Sun Jul 01 1990
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Duration of each developmental stage of the house dust mite Dermatophagoides pteronyssinus together with the mortality percentage were observed at a combination of five different temperatures namely 20C°, 22.5C°, 25C°, 27.5C° and 30C° and four different humidities namely 55%, 75%, 85% and 95% r. h. Results showed that temperature had the greatest effect on the life cycle period. The higher the temperature the shorter the life cycle was aid versa verea. On the other hand, humidity seems to be less effectiveness, though at the higher temperature and humidity no development was occured. Mortality among all temperatures and humidities appeared nearly the same, but at higher temperature and higher humidity and because of mould g

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Transcatheter balloon valvuloplasty for children with severe pulmonary valve stenosis: A single-center experience
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