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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 Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Disadvantages of Abortion and its Impact on Society
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As we have said that the reasons for abortion are many and varied them to be for
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of an act intended purpose of birth control or other reasons is the statistics that are
spread in the world that about 50-60 million abortions annually in the world If this
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the progressive and liberal, secular, and because they were not able to maintain
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Publication Date
Sun Dec 31 2023
Journal Name
College Of Islamic Sciences
Variation in general formulas in the strength of its foundation and the reasons for the discrepancy
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A legal discourse in the Qur’an and Sunnah is almost devoid of the use of one of the general formulas, and due to its frequent rotation in the tongue of the legislator, the formulas may overlap their members in apparently contradictory provisions, which makes the individual from the general members appear to the beholder to be covered by two contradictory provisions, and this research came to present what might happen to him The legal text interpreter of weighting between the two opposing texts is the strength of the generality that is established by the generality formula, so the two strongest formulas in the inclusion of its members outweigh the weaker of them and precede them, and the research decided that the formulas vary

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Sun Aug 24 2025
Journal Name
Al-anbar University Journal Of Law And Political Sciences
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Tue Jan 09 2024
Journal Name
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Sun Jul 01 2012
Journal Name
American Journal Of Veterinary Research
Effect of brachycephalic, mesaticephalic, and dolichocephalic head conformations on olfactory bulb angle and orientation in dogs as determined by use of in vivo magnetic resonance imaging
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The path and its nodal purposes
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Publication Date
Tue Sep 15 2020
Journal Name
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The impact of various staining substances and immersion time on the stainability of bonded sapphire brackets with three kinds of light cure orthodontic adhesives (An in-vitro study)
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Tue Jan 01 2019
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Wed Feb 01 2017
Journal Name
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