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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
Thu Jun 01 2023
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The Role of Criminal Policy in Iraq in Protecting and Improving the Environment
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Journal Of Physics: Conference Series
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Genetic Insights Into Psoriasis Therapy: A Review of Polymorphisms in the Genes of Both TNF-α and the TNF Signaling Pathway on the Response to Anti-TNF-α
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Tumor necrosis factor-alpha (TNF-α) inhibitors are widely used as first-line treatments for moderate to severe plaque psoriasis, yet clinical responses vary considerably among patients despite their overall safety and efficacy. Genetic factors that influence the effectiveness of biologic therapies may contribute to this variability. This review, conducted between May and ...

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Baghdad Science Journal
the effect of ethanol on the level of sialic acid in the brain
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Sun Oct 06 2024
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Self-criticism is that a person confronts himself with his mistakes in order to reform and develop them for the better, motivate them and inspire hope in them to push them forward and continue to give in this life. The Holy Qur’an teaches us, through the models it cited in its verses, that this is through repentance, a feeling of remorse, and a determination to leave mistakes, and quit disobedience and sins, etc., and all this is done through constructive criticism, and at the same time, one must realize his strengths. , in order to succeed in preserving it and employing it in the right path that pleases God, His Messenger, himself and his society. This has been explained through an introduction, two topics and a conclusion, and God is t

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Globalization as phenomena has affected   all aspects of life and reflected its impacts to the Arab world politically, economically, and culturally and became a vital field that related directly to our life. This field of searching needs as many studies and Academics as for employing the means that needed to face a national challenge which targeting the Arabic man Character in its ethics and values. This very important thing needs a very important reaction to face that challenge to protect the cultural ARABIC & ISLAMIC characteristics and to take care of education in all its levels and   forms as it is an invincible fort. For that, this field has become as the priority of the studying and researches if the

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Fri Dec 01 2017
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Most cultivars of sorghum have low field emergence as common problem. Three experiments were carried out at Agriculture College, Baghdad University. First experiment was conducted in laboratory according to Complete Randomized Design (CRD) with four replicates. Second and third experiments were conducted at field according to Randomized Complete Block Design (RCBD) during the spring and the fall seasons of 2015, respectively, with four replicates for each one. Same two factors were studied at each experiment. First factor was seed priming by seed soaking for 10 hours in distilled water, solvents of GA3, KCl and thiamine (300, 40 and 30 mg*L-1, respectively) and non-primed seed. Second factor was three cultivars of sorghum (Inqath, Kafier an

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