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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
Journal Name
Iraqi Journal Of Physics
Preparation of SiO2:TiO2 for High-Performance Double Layer Anti-Reflection Coating
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Publication Date
Mon Oct 21 2019
Journal Name
Civil Engineering Journal
Non-Smooth Behavior of Reinforced Concrete Beam Using Extended Finite Element Method
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Mon Jan 01 2018
Journal Name
Aip Conference Proceedings
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Flexural Behavior of Pultruded GFRP–Concrete Composite Beams Strengthened with GFRP Stiffeners
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Mon Feb 28 2022
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Sun Feb 25 2024
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An Adaptive Harmony Search Part-of-Speech tagger for Square Hmong Corpus
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Data-driven models perform poorly on part-of-speech tagging problems with the square Hmong language, a low-resource corpus. This paper designs a weight evaluation function to reduce the influence of unknown words. It proposes an improved harmony search algorithm utilizing the roulette and local evaluation strategies for handling the square Hmong part-of-speech tagging problem. The experiment shows that the average accuracy of the proposed model is 6%, 8% more than HMM and BiLSTM-CRF models, respectively. Meanwhile, the average F1 of the proposed model is also 6%, 3% more than HMM and BiLSTM-CRF models, respectively.

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Thu Mar 10 2022
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Publication Date
Mon Nov 01 2021
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Publication Date
Wed May 30 2018
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Publication Date
Thu Dec 06 2018
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
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 Inflammatory bowel disease includes both Crohn’s disease and ulcerative colitis, is a chronic, progressive relapsing disease of gastrointestinal tract that require long-term treatment or maintenance therapy. Taking patient’s beliefs about the prescribed medication in consideration had been shown to be an important factor that affects compliance of the patient in whom having positive beliefs is a prerequisite for better compliance. The aim of the current study was to investigate and assess beliefs about medicines among a sample of Iraqi patients with inflammatory bowel disease and to determine possible association between these beliefs and some patient-specific factors.

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