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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
Tue Jul 14 2015
Journal Name
Ibn Al-haitham J. For Pure & Appl. Sci.
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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Publication Date
Wed May 14 2025
Journal Name
Journal Of Applied Mathematics
Role of Wind and Fear on the Dynamic of a Prey and Two Competing Predators
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Publication Date
Thu Dec 19 2019
Journal Name
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Employment of the Roundhouse Strategy and its Impact on Academic Achievement and Core Thinking
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The aim of this research is to employ the roundhouse strategy to study its impact on the students achievement of the 10th grade in physics and their core thinking. After the application of the research experience and gaining data, which was processed statistically using the statistical packages program (SPSS). The results of the researcher revealed the superiority of the students of the experimental group who studied using the roundhouse strategy on the students of the control group who studied the usual method in the achievement test. As results showed that there were statistically significant differences between the average scores of the experimental group and the average scores of the control group students in the core thinking test and

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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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Publication Date
Mon Jan 01 2024
Journal Name
Baghdad Science Journal
Acute Toxicity of Chlorpyrifos on the Freshwater Bivalves (Unio Tigridis) and Effects on Bioindicators
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Publication Date
Sun Jun 02 2019
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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
The role of governors and Arab workers in helping the needy and the poor in the eras Rashidin and Umayyad
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The research deals with financial and supplies support from the rulers and governors of the
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Publication Date
Thu Jun 15 2023
Journal Name
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The Effectiveness of a Cognitive-Behavioral Treatment Program to Reduce Nervous Fatigue for Mothers of Children with Cerebral Palsy
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Cognitive-behavioral therapy is one of the most important relatively recent; treatment programs that attempt to modify behavior and control psychological disorders by modifying the individual's thinking style and awareness of himself and his environment, and cognitive reconstruction by replacing negative thoughts with positive ones. The current study aimed to know the effectiveness of a cognitive behavioral treatment program in reducing nervous fatigue among mothers of children with cerebral palsy. The sample on which the nervous fatigue scale was applied consisted of (30) mothers whose son suffers from cerebral palsy, and the results indicated that (24) mothers suffer from nervous fatigue. This sample was divided

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Publication Date
Sun Oct 01 2023
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Molecular detection by some virulence genes of Salmonella enterica subsp. enterica isolated from the stool of children with diarrhea
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Diarrhea is a real disease in childhood which could cause death. Therefore, this study was conducted to isolate Salmonella from 350 stool samples taken from children under five years in age, suffering from diarrhea during the period from March 2019 to March 2020 in Tikrit city / Iraq. The results showed the possibility to isolate ten isolates of Salmonella enterica subsp. Enterica, an infection rate, represents 2.875% of the total rate of patients who suffer from diarrhea. The virulence genes were investigated for ten isolates of S. enterica subsp. enterica, the result is that all isolates possessed the genes stn, invA, lpfA with an appearance percentage of 100%, whi

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Publication Date
Sat Sep 30 2023
Journal Name
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The Prophetic Speeches (Hadith) on Sciences and Scientists: Application of the "Text from Text and D+" Theory
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This study aims to apply the theory of "Text from Text and the Plus Dimension" in the analysis of the Prophetic discourse found in the section on the virtues of knowledge and scholars from Imam Sahih al-Bukhari's book. This section covers several topics, including the virtue of gathering for the sake of learning, the superiority of a scholar over a worshipper, the excellence of jurisprudence in the religion of Allah, the acquisition of knowledge through the passing away of scholars, the merit of inviting people to Allah, the continuing benefit of beneficial knowledge after a scholar's demise, the warning against seeking knowledge for purposes other than Allah, and the Prophet seeking refuge from knowledge tha

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