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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
Wed Jul 16 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of the effect of root canal preparation size and flaring on the depth of irrigant penetration (In vitro study)
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Background: Cleaning and shaping of root canals successfully requires high volumes of irrigation solutions that can only be applied to the apical third of root canal after enlargement with instrument, so the aim of this study was to evaluate and to compare the efficiency of Maxi-I-probe (side-vented needle), in the amount of root canal irrigant penetration for five different master apical file sizes (MAF) and four different degrees of coronal and middle thirds flaring. Materials and Methods: Two hundred resin blocks with simulated root canals were used in this study and divided into 5 major groups (40 for each) based on the size of master apical files (#20, #25, #30, #35, and #40). Each major group was subdivided into 4 subgroups depending

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Publication Date
Wed Jul 01 2020
Journal Name
Plant Archives
Effect of sedimentation source on the nature occurrence and distribution of the feldspar in some soil of Alluvial plain Iraq
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The current study was conducted to find out the effect of the sediment source (sedimentary of Iraqi-Iranian borderline and Tigris River) on the content and distribution of feldspar minerals and their effect on the optical properties of these minerals in some soils of Wasit and Maysan province. Eight pedons were chosen to represent the study area, five of them represented sediments coming from the borderline, which included pedons of (Badra, Taj Al-Din, Al-Shihabi, Jassan, and Galat), while two of them represent the sediments of the Tigris River (Essaouira, Al-Dabouni). Finally, the pedon of Ali Al-Gharbi represented the mixing area of sediments of all the torrents coming from borderline and the sediments of the Tigris River. The diagnostic

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Publication Date
Wed Sep 27 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation of the Genotoxicity of the Aerial Parts of Iraqi Euphorbia cyathophora on Bone Marrow and Spleen Cells in Mice
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The aim of the study was extraction of arial part of Euphorbia cyathophora constituents with methanol and evaluate its effect on mitotic index and total chromosomal aberration bone marrow cell and spleen cell in mice  200 gm of E. cyathophora fine powder was defatted then extracted by cold maceration 80% ethanol for seven days. The extract was filtered and dried in a rotary evaporator then the dried extract was suspended with water and consecutively extracted using chloroform, ethyl acetate for each. The aqueous layer was then mixed with 100ml methanol. These fractions are dried under reduced pressure to obtain the dry extract. Twenty-four Albino mice were used for the experiment. The animals were divided into four groups: Gr

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Thu Dec 19 2019
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Employment of the Roundhouse Strategy and its Impact on Academic Achievement and Core Thinking
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Publication Date
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
Illiteracy and its Impact on the Reality of Iraqi Youth between Heritage and Contemporary
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Illiteracy has spread in the last years, although it was eliminated in the 1980s. The return of illiteracy brings ignorance, illness, backwardness and regression among nations. It has taken many types, mainly alphabetical, scientific and computer illiteracy. Hence, the increasing nature of illiteracy has attracted the attention of governments and societies alike. This may touch the reality of societies starting with their youth unless those, who are in charge, will find workable solutions for the existing problems. The results of the study revealed that there is a real disaster awaiting the next generation after years of stray, and ignorance of the people in charge who are too engaged in getting their privileges to care about this proble

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Thu Mar 01 2012
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Mon Jan 02 2023
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The influence of socioeconomic status and general health on the fracture incidence
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Background/Aim There is an association between patient general health, socioeconomic status and fracture incidence. Aim of this study was to demonstrate the relation between the socioeconomic and health status and the occurrence of fractures in Al-Kindy Hospital residents. Methods A prospective cross-sectional study was performed by using data collected from fractured patients in Al-Kindy Teaching Hospital / Baghdad Orthopaedics Outpatient Clinic, between 12 December 2021 and 8 March 2022. A hundred patients aged 20 to 75 years were included in this study. The data were collected using a researcher-administered questionnaire, which included items to assess patient's socioeconomic status (accommodations, occupation, income status, level of e

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Scopus
Publication Date
Mon Apr 17 2017
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Effect of Water Stress and Hydrogen Peroxide and Potassium on the Growth and Yield of (Zea mays L.)
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Publication Date
Wed May 14 2025
Journal Name
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Role of Wind and Fear on the Dynamic of a Prey and Two Competing Predators
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Effect of Annealing Temperature and Thickness on the Structural and Optical Properties of CdSeThin Films
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CdSe alloy has been prepared successfully from its high purity elements. Thin films of this alloy with different thicknesses (300,700)nm have been grown on glass substrates at room temperature under very low pressure (10-5)Torr with rate of deposition (1.7)nm/sec by thermal evaporation technique, after that these thin films have been heat treated under low pressure (10-2)Torr at (473,673)K for one hour. X-ray patterns showed that both CdSe alloy and thin films are polycrystalline and have the hexagonal structure with preferential orientation in the [100] and [002] direction respectively. The optical measurements indicated that CdSe thin films have allowed direct optical energy band gap, and it increases from (1.77- 1.84) eV and from

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