A Comparison of Ketorolac, Diclofenac and Paracetamol for Postoperative Analgesia Following Abdominal Hysterectomy

Gaurav, Kumar; Sherif, Lulu

doi:10.14260/jemds/2015/2337

Cited by 3 publications

(4 citation statements)

References 7 publications

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“…This clearly appeared in three previous studies done in different countries showing that ketorolac had a higher analgesic effect than diclofenac and paracetamol after surgery (44)(45)(46) , and also agrees with another retrospective study in 2016 showing that ketorolac after appendectomy significantly decreases the pain score during the first day of surgery in pediatric patients (47) . This conclusion was also presented with different surgical procedures both in adults (48)(49)(50) and children (47,50) . Another study in Korea showed that iv paracetamol (1g) has the same level of pain relief after surgery as iv ketorolac (30 mg) in patients who underwent thyroidectomy, this made paracetamol an effective alternative to ketorolac in case of mild to moderate pain after surgery (51) .…”

Section: Discussionmentioning

confidence: 70%

Comparing the Efficacy of Paracetamol, Diclofenac, and Ketorolac on Post-Appendectomy Outcomes in Children and Adolescents

Alshaeer

Anwer²

2020

IJPS

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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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Section: Discussionmentioning

confidence: 70%

Comparing the Efficacy of Paracetamol, Diclofenac, and Ketorolac on Post-Appendectomy Outcomes in Children and Adolescents

Alshaeer

Anwer²

2020

IJPS

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“…A research by Kumar et al, found that intravenous paracetamol and intravenous ketorolac reduced post-operative pain in patients having gynaecological abdominal surgery (hysterectomy) by 2.25 ± 0.44 and 1.88 ± 0.34, respectively 15 . Further research by Kumar G et al compared the effectiveness of ketorolac 30mg IV to that of diclofenac 75mg IV and paracetamol 1gm IV, and showed that patients who got ketorolac had a considerably lower VAS score than those who received diclofenac.…”

Section: Discussionmentioning

confidence: 99%

“…Non-steroidal anti-inflammatory medication (NSAID) ketorolac is. It has been found to have opioid sparing effects and is utilised for the short-term treatment of moderate to severe pain by lowering the synthesis of prostaglandins 14,15 .…”

Section: Discussionmentioning

confidence: 99%

To Compare the Mean Postoperative Pain Score between Intravenous Paracetamol Vs Intravenous Ketorolac among patients undergoing Gynecological Abdominal Surgery

Chaudhary¹,

Iqbal²,

Zia³

et al. 2022

PJMHS

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Background: Post-operative pain is one of the common concerns in all the surgical interventions including gynecological surgeries. There is always a need for the agent with better efficacy and minimal side effect profiles. Aim: To compare the mean postoperative pain score between intravenous Paracetamol vs intravenous ketorolac among patients undergoing gynecological abdominal surgery Study design: Randomized Controlled Trial Setting & duration: Department of Anesthesia, Hameed Latif Hospital, Lahore from 12-06-2018 to 12-12-2018 Methodology: In this study, females with age 20 - 50 years with ASA I and II undergoing gynecological abdominal surgery were included. Group A was administered with intravenous paracetamol and group B with ketorolac. Pain was measured in terms of mean of numerical rating scale recorded at 12 hours postoperatively. Results: In the present study there were total 80 cases included, 40 in each group. The mean age in group B was 37.66±12.67 years and in group A was 41.29±11.36 years Mean post operative pain score was 3.05±0.61vs 3.56±0.89 in group B and A with p= 0.04 Mean post operative pain was 3.04±0.61 vs 3.51±0.77 with p= 0.03 in cases with BMI > 25. There was no significant difference in terms of type of procedure and mean pain score in both groups. Conclusion: Ketorolac is significantly better than Paracetamol in gynecological abdominal surgeries and this difference is also significantly better in cases with BMI > 25. Keywords: Pain, ketorolac, paracetamol, BMI

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“…[18][19][20] Usage of ketorolac significantly lower pain score even after few days of appendectomy. This indicates that ketorolac has higher efficacy and analgesic potency than other NSAIDS as it readily available to the body and its rapid onset of action 21 .…”

Section: Discussionmentioning

confidence: 99%

Comparison between Diclofenac Sodium and Ketorolac in the Management of Post-Appendectomy Pain

Jahan,

Malik,

Imran

et al. 2024

PJMHS

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Aim: To compare the Diclofenac Sodium and ketorolac in the management of post-appendectomy pain. Study design: Single blinded analytical comparative trial Place and duration of study: Tertiary Care Hospital, Lahore from 01-03-2022 to 30-11-2022. Methodology: One hundred and twenty three patients within 8-48 years who were suffering from acute appendicitis and required appendectomy were randomly selected. They were randomly divided into two groups. One was Diclofenac sodium group which had 61 cases in it and was selected to receive Diclofenac Sodium post-surgery. The other group having 62 patients was ketorolac group receiving ketorolac for pain relief. The patients received the pain killer post 30 and then 60 minutes after their surgery. The comparative results and efficacy of each pain killer was analyzed and assessed through faces pain scale. Results: The mean age of the patients was 20.5±5.5 in diclofenac sodium and 21.3±6.1 in Ketorolac group. There were 75.4% males in former group while 62.9% in later group. The mean value of BMI was within normal range in both groups. The pain score recorded highest number of cases in Diclofenac Sodium and ketorolac group at score 02 within 30 minutes after surgery while the pain score significantly dropped in ketorolac group in 60 minutes to score 00 while it persisted highest in score 02 among patients given Diclofenac Sodium. Conclusion: Intravenous ketorolac has advanced analgesic effect than Diclofenac Sodium with a substantial low risk involved in cases of appendectomy. Key Words: Appendicitis, NSAIDS, Ketorolac, Diclofenac, Management.

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A Comparison of Ketorolac, Diclofenac and Paracetamol for Postoperative Analgesia Following Abdominal Hysterectomy

Abstract: BACKGROUNDAbdominal hysterectomy is associated with moderate-to-severe postoperative pain. Among non-opioid analgesics diclofenac, paracetamol and ketorolac are most commonly used.

Cited by 3 publications

References 7 publications

Comparing the Efficacy of Paracetamol, Diclofenac, and Ketorolac on Post-Appendectomy Outcomes in Children and Adolescents

Comparing the Efficacy of Paracetamol, Diclofenac, and Ketorolac on Post-Appendectomy Outcomes in Children and Adolescents

To Compare the Mean Postoperative Pain Score between Intravenous Paracetamol Vs Intravenous Ketorolac among patients undergoing Gynecological Abdominal Surgery

Comparison between Diclofenac Sodium and Ketorolac in the Management of Post-Appendectomy Pain

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