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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
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Taste Detection Thresholds in Relation to Salivary and Serum Zinc in Patients on Simvastatin Treatment
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Background: Hyperlipidemia is an elevated fat (lipids), mostly cholesterol and triglycerides, in the blood. These lipids usually bind to proteins to remain circulated so-called lipoprotein. Aims of the study: To determine taste detection threshold and estimate the trace elements (zinc) in serum and saliva of those patients and compare all of these with healthy control subjects. Methods: Eighty subjects were incorporated in this study, thy were divided into two groups: forty patients on simvastatin treatment age between (35-60) years, and forty healthy control of age range between (35-60) years. Saliva was collected by non-stimulated technique within 10 minutes. Serum was obtained from each subject. Zinc was estimated in serum and saliva

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Publication Date
Thu Dec 31 2020
Journal Name
Political Sciences Journal
The influence of the political and social socialization in the trend towards extremism
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The research deals with the impact of the nature of social and political formation in the orientation towards extremism through tracking the institutions and beliefs that the individual is going through. The role of the family, the group, the school, education, and religion has been touched upon in acquiring the trends of extremism, whether publicly or covertly, Focusing on the social and economic contexts that are an incubator environment for extremism supported by the form of the group and the beliefs it espouses, whether direct through religion or indirectly through the nature of education, this study relied on political literature that addressed this The topic, which focused on the phenomenon of extremism that swept the world recentl

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Publication Date
Tue May 07 2019
Journal Name
Journal Of Planner And Development
the role of the economy in protecting the environment from pollution and decision_making
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The economic dimensions of environmental issues are complex and unclear in many cases, there is a kind of confusion in the real relationship between economic growth and environmental regulations. Many of the negative environmental impacts are accompanied by human activities and urban and industrial development in the city, and that many of the projects that did not take into account the environmental factors during the planning and implementation of them can be detrimental, as well as natural environments, archeological sites, historical or scientific value, aesthetic or educational. It also describes the Global Environment Outlook that if current trends continue, population growth, economic growth and consumption patterns, the p

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Publication Date
Sun Mar 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
THE REALITY OF THE AGRICULTURL SECTOR IN IRAQ AND CHALLENGES FACING THE FUTURE
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Publication Date
Fri Jan 01 2021
Journal Name
International Journal Of Clinical Dentistry Preview Publication Details
The effect of surgical approaches on the stability and marginal bone loss of early loaded slactive implants with screw retention mean: Comparative clinical and radiological prospective study
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Publication Date
Fri Oct 02 2020
Journal Name
International Development Planning Review
COMPARISON OF THE PERFORMANCE OF THE FOREHANDKICK (STRAIGHT AND ACCOMPANIED BY FORWARD ROTATION) IN TERMS OF ACCURACY AND SPEED AMONG THE PLAYERS OF THE NATIONAL TEAM (ADVANCED CATEGORY) IN TENNIS
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Sun May 15 2016
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Population growth and the culture of consumption A field study in the city of Arbil.: Population growth and the culture of consumption A field study in the city of Arbil.
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research objectives to:
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2. detect the consumption culture among the population in the city of Erbil.
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Publication Date
Wed Oct 02 2024
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COMPARISON OF THE PERFORMANCE OF THE FOREHANDKICK (STRAIGHT AND ACCOMPANIED BY FORWARD ROTATION) IN TERMS OF ACCURACY AND SPEED AMONG THE PLAYERS OF THE NATIONAL TEAM (ADVANCED CATEGORY) IN TENNIS
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COMPARISON OF THE PERFORMANCE OF THE FOREHANDKICK (STRAIGHT AND ACCOMPANIED BY FORWARD ROTATION) IN TERMS OF ACCURACY AND SPEED AMONG THE PLAYERS OF THE NATIONAL TEAM (ADVANCED CATEGORY) IN TENNIS
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Wed Oct 02 2024
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