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bijps-974
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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Sun Oct 01 2023
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Mon Jan 01 2018
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Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
T-Cells Proliferation and Serum Cytokine levels in Type 1 Diabetic Children
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The study aimed to dhed the light on the digital addiction in a spectrum child Autism
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in the autism spectrum، and identifying the relationship between electronic addiction and the social isolation of children in the autism spectrum.The study presented
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Publication Date
Sat Jun 30 2007
Journal Name
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Parental Perception of Fever in Children
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Back ground : Fever is a common medical problem in
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harmful effects of fever in their children. Resulting in
inappropriate management of fever in their children.
Objective: the objective of this study was to survey
parents about their knowledge andattitude concerning fever
in their children.
Methods : The study involved random selection of
parents who brought their febrile children to emergency
department or out-patient clinics of five teaching and non
teaching hospitals in Baghdad from first of October to end
of December 2002.
Parents of 400 febrile children were interviewed using a
standard questionnaire to obtain sociodemographic
informatio

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