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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 Jul 01 1996
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
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Identification of pathogens and locating their inocul¬um source (S) are the first strategies toward successful disease management program the pretransplating seedl¬ing damping - off problem on vegetable crops was found to be caused by Pythium aphanidermatum and Rhizocto¬nia solani. Both fungi were isolated from peat (moss) for the first time in Iraq. In addition, considerable num¬ber of pathogenic fungi was found as contaminants in soil samples from Alrashidiah vegetable covered farming station. Among the isolated fungi were: Pythium apha¬nidermatum, Rhizoctonia solani, Sclerotinia sclerotiorum, Fusarium oxysporum, Fusarium solani phialophora spp., Cephalisporium spp Rizopus stolonfier and Botrytis cine¬rea, in addition to several

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Wed Sep 11 2024
Journal Name
Lecture Notes In Civil Engineering
An Image Processing Algorithm to Address the Problem of Stains Merge on Water Sensitive Papers and Its Impact on the Evaluation of Spray Quality Indicators
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There are many techniques that can be used to estimate the spray quality traits such as the spray coverage, droplet density, droplet count, and droplet diameter. One of the most common techniques is to use water sensitive papers (WSP) as a spray collector on field conditions and analyzing them using several software. However, possible merger of some droplets could occur after they deposit on WSP, and this could affect the accuracy of the results. In this research, image processing technique was used for better estimation of the spray traits, and to overcome the problem of droplet merger. The droplets were classified as non-merged and merged droplets based on their roundness, then the merged droplets were separated based on the average non-m

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Wed Jan 01 2020
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Publication Date
Tue Dec 30 2014
Journal Name
College Of Islamic Sciences
Investigations in the sanctity of divine texts and their composition: (Comparative study between the Quran and the Torah)
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The research deals with an important issue that many people are working on, namely the sanctification of the texts on which the timings of the time and the different conditions of the place took place. Do not live up to the ranks of perfection and perfection, and every effort has explanations according to the mind machine, which is not protected by infallibility from error. The great downfall is to put these intellectual efforts in the Bible without separating them from the Word of God. The situation and the place on the adherents of a religion and mixed with the trick of the average individual only to be subject to the words of the teachers of Sharia and docility.

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Wed Jan 22 2020
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