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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 Nov 11 2014
Journal Name
Pakistan Journal Of Biological Sciences
Effects of Local Curcumin on Oxidative Stress and Total Antioxidant Capacity in vivo Study
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Publication Date
Sun Dec 03 2017
Journal Name
Journal Of Babylon University
Spectrophotometric Determination of Sulfamethoxazole in Pure and Pharmaceutical Preparations Based on Condensation Reaction Method
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A new, Simple, sensitive and accurate spectrophotometric methods have been developed for the determination of sulfamethoxazole (SMZ) drug in pure and dosage forms. This method based on the reaction of sulfamethoxazole (SMZ) with 1,2-napthoquinone-4-sulphonic acid (NQS) to form Nalkylamono naphthoquinone by replacement of the sulphonate group of the naphthoquinone sulphonic acid by an amino group. The colored chromogen shows absorption maximum at 460 nm. The optimum conditions of condensation reaction forms were investigated by (1) univariable method, by optimizing the effect of experimental variables (different bases, reagent concentration, borax concentration and reaction time), (2) central composite design (CCD) including the effect of

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Publication Date
Tue Apr 19 2022
Journal Name
Al Mustansiriyah Journal Of Pharmaceutical Sciences
Effect of pioglitazone treatment on serum chemerin and vaspin levels in polycystic ovary syndrome.
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Abdominal fat synthesizes a variety of adipokines, including vaspin and chemerin, that affect the resistance to insulin. This research was conducted to demonstrate the effect of pioglitazone, one insulin sensitizer used to decrease insulin resistance, on these adipokines in   obese patients with polycystic ovary (PCOS). Twenty-five obese women with PCOS were treated with pioglitazone 15mg/bid for 12 weeks. Modifications in fasting blood glucose (FBG), serum fasting insulin (FSI), chemerin and vaspin serum levels, follicle stimulation hormone (FSH), luteinizing hormone (LH), testosterone (T), and in baseline and post-therapy were assessed. Body mass index decreased without any substantial variance after 12 weeks of piogl

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Publication Date
Sun Mar 02 2008
Journal Name
Baghdad Science Journal
Effect of Saline Water and Potassium Fertilizer on Nitrogen Fixation in Pisum sativum L.
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Field experiment was conducted to test the effect of saline water 2 and7 dSm-1 potassium fertilizer rate 150,300 and 450 kg/donum on nitrogen fixation in Pisum sativum L. nodules. The experiment included anatomy study .Results water salinity ( 2,7 dSm-1) as a main plot and fertilizer rates as a sub plot. Results indicated that irrigation with saline water 7 dSm-¹ caused a significant decrease in N contents especially in the lower parts of the plants. The percentage of the N decreased in lower leaves to (0.01%) under 7dSm-¹ and 300 kg/donum fertilizer; however the percentage increased in the upper leaves to (2.80%) under with 2dSm-¹of irrigation water and 300 kg/ donum fertilizer rate. Fresh weight decreased to 6.26g under 7 dSm

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Thu Aug 31 2017
Journal Name
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Experimental study on performance of laterally loaded plumb and battered piles in layered sand
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Publication Date
Fri Mar 31 2017
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Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Metformin and Antioxidant Agents on Hirsutism in Women with Polycystic Ovary Syndrome
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Sun Jun 30 2013
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Effect of Solid Particle Properties on Heat Transfer and Pressure Drop in Packed Duct
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Publication Date
Sun Aug 17 2025
Journal Name
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Effect of Periodontal Therapy on Serum and Salivary Interleukin-2 Levels in Chronic Periodontitis
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Sun Jan 01 2023
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Efficiency of plant extracts on Aspergillus growth and aflatoxin B1 production in Zea mays
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