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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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Publication Date
Mon May 22 2023
Journal Name
Bangladesh Journal Of Medical Science
Genotyping of Escherichia coli isolated from diarrhea cases in children under five years of age using the PFGE method
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Fri Jan 01 2016
Journal Name
The International Scientific Conference For Nanotechnology And Advance Research’s
Effect of the annealing and compositional on the Morphological and electrical
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Nanocrystalline TiO 2 and CuO doped TiO 2 thin films were successfully deposited on suitably cleaned glass substrate at constant room temperature and different concentrations of CuO (0.05,0.1,0.15,0.2) wt% using pulse laser deposition(PLD) technique at a constant deposition parameter such as : (pulse Nd:YAG laser with λ=1064 nm, constant energy 800 mJ, with repetition rate 6 Hz and No. of pulse (500). The films were annealed at different annealing temperatures 423K and 523 K. The effect of annealing on the morphological and electrical properties was studied. Surface morphology of the thin films has been studied by using atomic force microscopes which showed that the films have good crystalline and homogeneous surface. The Root M

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Thu May 05 2022
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Safety profile of immediate post-partum intrauterine device insertion during caesarean delivery – a clinical trial with three years of follow up: Utility of Immediate Post Placental Insertion of Intrauterine Device During Cesarean Delivery
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Tue Dec 01 2020
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Breast cancer is one of the most important malignant diseases all over the world. The incidence of breast cancer is increasing around the world and it is still the leading cause of cancer mortality An Approximately 1.3 million new cases were diagnosed worldwide last year. With areas rising increasing, risk factors for breast cancer including obesity, early menarche, alcohol and smoking, environmental contamination and reduced or late birth rates become more prevalent. In Iraq, breast cancer ranks first among types of cancers diagnosed in women. This study was conducted on one hundred twenty women with breast cancer that was evaluated and investigated for the possible role of the risk factors on the development of breast cancer in females. T

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Sat Sep 03 2022
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Using Elisa and nested PCR for detection of the toxoplasmosis in milk and the influence of infection and some factors on milk composition in the Iraqi local and Shami goats
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Tue Jan 01 2019
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Bloody Diarrhoea anl0ng Children under five years of Age in Tikirit Teaching Hospital
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methods Ahospital based study was carried out at tikreet 5years age who were admitted to Tikreet Teaching Hospital
teaching Hospital in Tikreet city on 133 children who were in Tikreet city , There is astrong positive relationship
admitted to the hospital with bloody diarrehea their ages between the occurrence of bloody diarrehea and the type of
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Thu Jan 30 2020
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Pattern of Congenital Heart Disease In Children Attending Central Teaching Pediatric Hospital, Baghdad
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