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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
Tue Apr 30 2013
Journal Name
International Journal Of Microbiology Research
IDENTIFICATION AND TYPING OF Haemophilus influenzae IN IRAQI CHILDREN DIAGNOSED WITH MENINGITIS
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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
The Contribution of Behavioral Disorders to Predicting Bullying Patterns in a Sample of Adolescents with Autism Spectrum Disorder: College of Education and Arts - Northern Border University - Kingdom of Saudi Arabia.
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The present study aims to identify the role of behavioral disorders (anxiety disorder, behavior disorder "behavior", confrontation and challenge disorder, aggressive behavior) in predicting bullying patterns (verbal, physical, electronic, school) in a sample of adolescents with autism spectrum disorder. For this purpose, the researcher developed scales to measure the behavioral disorders and the bullying patterns among adolescents with autism spectrum disorder. The researcher adopted the descriptive survey approach. The study sample consists of (80) adolescents with autism spectrum disorder with ages range from (15-19 years) and (45-53 years old) in association with israr association for people with special needs in the northern borders

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Publication Date
Tue Aug 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Post a reflection on the capabilities of personnel programs A prospective study of a sample of the views of the staff at the Ministry of Higher Education and Scientific Research
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Publication Date
Wed Dec 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Efficacy of Papacarie in Reduction Total Bacterial Count in Comparison with the Conventional Rotary Method
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Background: The change in the concepts of cavity preparation and the development of reliable adhesive materials lead to the development of alternative methods of caries removal. Chemo-mechanical caries removal (CMCR) involves the chemical softening of carious dentin, followed by its removal with manual excavation. The present study was conducted to evaluate clinically the efficiency of caries removal using a new chemo-mechanical agent (Papacarie) compared to the conventional drilling method in reduction of total bacterial count. Material and methods: The study is a split mouth design. The sample composes from sixty mandibular deciduous molars teeth in thirty children, between six to nine years of age with bilateral class I deep occlusal car

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Publication Date
Sun Apr 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Standraidization of Post traumatic Stress Disorder Scale on Students of University of Baghdad
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Therefore, the aim of this study was to standardize the PTSD scale for students at Baghdad University. For the Psychologist Fua . E. which was applied in many foreign studies. 

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Publication Date
Wed Jan 01 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Health Educational Program on Nurses’ Knowledge About Communication Skills with Children at Welfare Children Teaching Hospital in Baghdad City
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Background: Therapeutic communication is the basis of interactive relationships among nursing team and their children: that affords opportunities to establish rapport, understand the client’s experience, formulate individualized or client interventions and optimize health care resources.

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Efficacy of Bacillus thuringiensis (Berliner) isolates on fig moth, Ephestia cautella (Walker) Larvae
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Publication Date
Sun Jan 19 2020
Journal Name
Biochemical And Cellular Archives
Isolation and characterization of phosphate solubilizing Pseudomonas species and assess its efficacy as plant growth promoter
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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Structural Model of the Relationship between Emotional Creativity and Self-Efficacy among Students at the Preparatory Year Tabuk University
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This research aimed to identify the structural model of the relationship between emotional creativity and self-efficacy among male and female students of the preparatory year at Tabuk University. The current study adopted the descriptive correlational approach, as it is appropriate to the nature of the study. The study tools contained (60) items that measure the relationship between emotional creativity and self-efficacy among the male and female students of the preparatory year at Tabuk University. The study sample was chosen by the stratified random method of the study community, where the study sample reached (183) male and female students of the preparatory year at the University of Tabuk. The results of the study showed that there a

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Publication Date
Sun Mar 06 2011
Journal Name
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Isolation and Identification of Vibrio cholerae causes Epidemic cholera 2007 in Iraq by Rapid Method (Immunochromatographic one step rapid visual test) and comparing it with the traditional Bacterlogical Methods
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