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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 Nov 05 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effect of Physiotherapy on the Motor Recovery and Improvement in Patients with Facial Palsy
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Objectives: The study aims to investigate the efficiency of physiotherapy methods to improve the
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Methodology: This study is carried out at the Rehabilitation Center-Baghdad from November 2009 till
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Publication Date
Sat Nov 10 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
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, 2013. A purposive (non-probability) sample of 300 laboring women was selected
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Publication Date
Sat Jan 20 2018
Journal Name
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The Influence of Thyroid Hormones on Leptin and Resistin Levels in Hyperthyroid Female Patients
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Hyperthyroidism or thyrotoxicosis occurs due to excess release of thyroid hormone. These hormones regulate the body’s energy balance and have effects on adipokine level. There are several reports suggesting interrelation between adipokines (resistin and leptin) with thyroid dysfunction. Objectives: This study was established to investigate the effect of thyroid hormones in hyperthyroidism state on the level of some adipokines, leptin and resistin; in comparison with control. Patients and Methods: The present study included 50 Iraqi female patients with hyperthyroidism with age ranged between 30-58 years and 30 healthy controls with age ranged between 30-53 years. Serum samples were collected from study groups. The levels of thyroid hormon

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