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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
Mon Jan 01 2024
Journal Name
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Eruption of first permanent molar among a group of Iraqi children in relation to nutritional status
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Background/Aim: The timing of a tooth's eruption can be affected by a variety of factors. The nutritional status has an impact on the development of a child's body. The purpose of the study was to analyse the number of children aged 6 to 9 in an Iraqi Arab population who had erupted permanent first molars and to examine how nutritional status affected the timing and level of emergence. Methods: A total of 330 boys and girls, in first grade elementary school, made up the sample. First molars that had erupted were noted, along with the level of the eruption. Each child's nutritional status was evaluated by recording their height and weight and body mass index (BMI) value was compared to the 2007 WHO reference. Results: Girls had highe

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Occurrence of Amoebic Versus Bacillary Dysentery among Children Under Five Years of Age in Baghdad City
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Fri Mar 01 2013
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The reality and fundamentals of the poultry industry and its implications on the prices of eggs and chickens in Iraq for the period from 2000 to 2009 (analytical study)
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Despite all the possibilities held by Iraq for the production of poultry , but there is low and clear in the level of production and a rise in costs and a decline in per capita consumption is due to a number of reasons, including poor investment , stop government subsides , dumping policies , market Bolmottagat imported , the contribution of the merchant squandering of national capacity , weak base material for the growth of this sector , the security situation and the crisis of energy and others .

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The impact of the Needham model on learning the skills of dribbling and handling in football for students
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Sun Jul 01 2018
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Sun Jan 05 2020
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THE EFFECT OF THE TRAINING CURRICULUM ON DEVELOPING KINETIC AND TRANSITIONAL RESPONSE SPEED, ACCURACY OF THE STOPPING WALL PERFORMANCE, AND DEFENDING THE STADIUM IN VOLLEYBALL
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