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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
Tue Aug 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Monitoring Changes in the Spectral Reflectivity of Baghdad City and the Impact of the Atmospheric Elements on it using R.S and GIS
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Publication Date
Fri Jun 30 2023
Journal Name
The International Tinnitus Journal
Is Topical Nasal Steroid Useful for Treatment of Otitis Media with Effusion in Children?
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Publication Date
Sun Jun 10 2018
Journal Name
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Lead among children with autism in Iraq. Is it a potential factor?
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Publication Date
Wed Sep 25 2024
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Maximum mouth opening measurement in relation to maximum bite force among children
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A COMPARATIVE STUDY OF THE CONSUMERS ATTITUDE ON THE MEAT HYGIENE SLAUGHTERED IN AND OUTSIDETHE SLAUGHTER HOUSEES: A COMPARATIVE STUDY OF THE CONSUMERS ATTITUDE ON THE MEAT HYGIENE SLAUGHTERED IN AND OUTSIDETHE SLAUGHTER HOUSEES
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Publication Date
Tue Jul 08 2025
Journal Name
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An Oral Health Status and Treatment Needed in Relation to Dental Knowledge, Among a Group of Children Attending Preventive Department, College of Dentistry, University of Baghdad
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Publication Date
Tue Oct 01 2013
Journal Name
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Comparing Between Shrinkage &Maximum likelihood Method For Estimation Parameters &Reliability Function With 3- Parameter Weibull Distribution By Using Simulation
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The 3-parameter Weibull distribution is used as a model for failure since this distribution is proper when the failure rate somewhat high in starting operation and these rates will be decreased with increasing time .

In practical side a comparison was made between (Shrinkage and Maximum likelihood) Estimators for parameter and reliability function using simulation , we conclude that the Shrinkage estimators for parameters are better than maximum likelihood estimators but the maximum likelihood estimator for reliability function is the better using statistical measures (MAPE)and (MSE) and for different sample sizes.

Note:- ns : small sample ; nm=median sample

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Publication Date
Thu Mar 03 2022
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Publication Date
Sun Aug 01 2021
Journal Name
Journal Of Education And Science
Evaluation of Salivary Alpha-Amylase level in Iraqi children with positive family history of hypertension
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This study accomplished to determine levels of salivary Alpha-Amylase (sAA) in Iraqi children with positive family history of hypertension, Hypertension was believed to be a risk factor in 18% of all deaths in 2010 (9.4 million globally). This study included one hundred children from primary school aged 6 to 13 years, with a focus in child welfare and family health history, with an emphasis on close relatives' hypertension reputations, with hypertension close relatives record categories identified by 1st and 2nd relatives, after documenting the full details, the burden was assessed for the children's families. The influence of age is confirmed by a correlation study of our own numbers, which shows a positive correlation. The disparity betwe

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Publication Date
Fri Dec 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
The Effect of Power Sources in the Agricultural Tractor and the Developed Sprayer System on the Performance of the Electrical and Mechanical Sprayer System and some Performance Indicators of the Engine
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