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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 Apr 20 2026
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Preparation and Annealing Effects on the Structural and Optical Properties of ZnTe Thin Film
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ZnTe possesses the proper optoelectronic properties as a candidate for device development. The structure and optical properties of ZnTe semiconductor thin films of 500 nm were studied using thermal evaporation technique. The influence of annealing temperatures on ZnTe thin films in the range ( R.T - 473 K). XRD and surface morphological analyses are used to examine the films. The ZnTe films are comparatively polycrystalline and cubic in phase, according to the XRD analysis. with a lattice constant of 0.61 nm upon an (111) orientation. The intensities of all the peaks rapidly increase though they show the same tendencies; it shows the crystallinity of the films becomes higher crystal size diameters (from 8.41 to 12.18nm) both increas

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Publication Date
Fri Oct 02 2026
Journal Name
Opción: Revista De Ciencias Humanas Y Sociales, Issn 1012-1587, Nº. Extra 21, 2019, Págs. 907-927
The Effect Of The Perkins’ And Blythe’s Model On Mathematical Communication Among Students Of The 5Th Bio Scientific Grade In Mathematics
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Autorías: Muayad Kadhim Raheem, Lina Fouad Jawad. Localización: Opción: Revista de Ciencias Humanas y Sociales. Nº. 21, 2019. Artículo de Revista en Dialnet.

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Publication Date
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
The Effect of Continuous Darkness and Continuous Light on the Reactivity of Smooth Muscles to Drugs in the Rat Vas Deferens
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Background: The vasoconstricting agents: nor-adrenaline and 5- hydroxytryptamine
(5-HT) have a stimulant action on smooth muscle contractility of the rat vas deferens.
Objective: This study aimed to investigate the effect of exposure to continuous
darkness and continuous light on the contractility of the vasa deferntia smooth
muscles from rats to applied nor-adrenaline and 5-HT.
Method: Male albino wistar rats were divided into 3 experimental groups. Group 1:
Control animals, were exposed to the ordinary photoperiod each day. Group 2: Rats
were kept in a dark room. Group 3: In a room under a bright artificial light.
All animals were killed after 4 weeks.
Results: Vasa deferentia preparations from continuous dar

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Publication Date
Mon May 19 2025
Journal Name
Retos
The effect of the cube model on visual-spatial intelligence and learning the skill of spiking in volleyball for female students
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Objective: To identify the effect of the cube model on visual-spatial intelligence and learning the skill of spikinging in volleyball for female students, The researchers used the experimental method by designing two equivalent groups with pre- and post-measurements. Research methodology: The main research sample of (30) female students was selected from the research community represented by second-stage students in the College of Physical Education and Sports Sciences - University of Baghdad for the academic year (2024-2025). The sample was divided equally into two control and experimental groups. The researchers conducted the sample homogenization process and the equivalence process between the two groups in the variables of visua

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Publication Date
Mon Jan 02 2023
Journal Name
Scripta Medica
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
Thu Mar 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
On the design of the annexation experience between splintered and dissociated sectors
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The idea of the design of combination Between split – plot and split block means that an experiment conducted with a design

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Crossref
Publication Date
Sat Mar 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Activating Financial Performance Measures On The Basis Of Value And Its Reflection On Companies Performance Under The Governance: An Applied Study On A sample Of Companies Listed In the Iraqi Stock Exchange
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Increased attention to corporate governance with the increasing need for investors and other parties in the Iraqi market for securities of the information credible and confidence and greater transparency in the disclosure as well as the systems of governance lead to raise the value of the company and that by reducing the cost of capital and reduce the cost of financing, as well as that there are indications modern measurement can be adopted by the Iraqi market for securities for the purpose of evaluating the performance of listed companies and then raise their value.

   The research problem is that there is no framework or structure of the legal and local rules for the application of corporate governance in Iraq obliges

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Publication Date
Sun May 08 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of the relationship between the internal auditor and the external auditor on the Earnings quality in Iraqi companies listed in the Iraqi Stock Exchange
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The changes that have occurred in the business environment and scientific and technological progress, as well as the complexity of administrative problems resulting from its practice of various activities, have led to an increase in the responsibilities entrusted to it, and for the purpose of achieving its strategic objectives, which has made the pillars of corporate governance an inevitable matter required by the nature of modern scientific management of the governorate, the success that companies seek is based on the fertile environment and the dialectical relationship between the individual and the company, and to achieve this success there must be a compatible and harmonious audit environment between the internal and external

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
Administrative coordination between the Federal Ministry and the local government and its impact on municipal performance An applied study in the municipalities of Dhi Qar Governorate
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       The aim of the research is to show the extent of the impact of administrative coordination on municipal performance after the state’s tendency to implement administrative decentralization and transfer of powers (administrative, legal, financial, and technical) from the Federal Ministry (construction, housing, municipalities, and public works) to local governments (governorates), to meet local needs, And since the municipality is considered one of the local administrative institutions and most of its goal is to provide increased municipal services to citizens due to population growth and urban expansion of cities by coordinating their actions using their powers, and in order to address gaps i

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Crossref
Publication Date
Mon Jan 01 2018
Journal Name
Al–bahith Al–a'alami
Political Marketing and the Formation of Trends in Public Opinion on Social Networking Sites: An Analytical Study of the Two F.B. Pages: the Prime Minister and the Parliament President
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The social networking sites have become one of the most important promotional instruments for their characteristic of facilitation of communication and the creation of public platform for discussion and formation of new points of view. These sites were used in the political marketing process where politicians use Facebook pages to promote their ideologies and spread their programs for the purpose of an influencing public opinion.
This research deals with the way by which political products are the Iraqi parliament. We adopt the methodology for analyzing the contents of these pages during three months starting from September,12 2016 to March 1, 2017 characterized by a lot of changes and events, in particular the beginning of the war o

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