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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 Jul 21 2025
Journal Name
Journal Of Physical Education
Proposed Exercises Using Flexible Resisters And Their Effect On Developing Strength Endurance And The Performance of Some Offensive Skills In Youth Basketball
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Fri Jan 01 2021
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Special Exercises For Offensive Tactical Skills And Their Impact On Developing The Speed And Accuracy Of Some Basic Skills In Youth Football
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Scopus
Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Banking Liberalization and its impact on Attracting Customers: applied research in a sample of Iraqi banks listed on the Iraq Stock Exchange
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The research aims to shed light on banking liberalization and explain its impact on attracting customers, especially since Iraq adopted this policy after (2003) due to the changes that occurred, as the Central Bank of Iraq granted flexibility to banks in setting the interest rate on deposits and loans as well as allowing the entry of foreign banks in the local environment. The research relied on the analytical method for the dimensions of banking liberalization represented by (liberating interest rates, liberating credit, legal reserve requirements, entering foreign banks, privatization) as well as the factors affecting the attraction of customers, and a number of Iraqi banks listed in the Iraqi Stock Exchange were selected as a

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Publication Date
Sun Jun 30 2013
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Al-khwarizmi Engineering Journal
Study on the Effect of the Curvature of Solar Collector on Wind Loading Coefficients and Dynamic Response of Solar Collector
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In the current research, the work concentrated on studying the effect of curvature of solar parabolic trough solar collector on wind loading coefficients and dynamic response of solar collector. The response of collector to the aerodynamic loading was estimated numerically and experimentally. The curvature of most public parabolic trough solar collectors was investigated and compared. The dynamic response of solar collector due to wind loading was investigated by using numerical solution of fluid-structure interaction concept. The experimental work was done to verify the numerical results and shows good agreement with numerical results. The numerical results were obtained by using finite element software package (ANSYS 14). It was found

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
Sustainable leadership and its impact on organizational happiness Analytical research in the General Tourism Authority in Baghdad
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      The current research aims to test the relationship of the impact of sustainable leadership as an independent variable in organizational happiness as a dependent variable, in the departments and divisions of the Tourism Authority, to come up with a set of recommendations that contribute to raising the level of organizational happiness in the authority. And based on the importance of the research topic in the General Authority, and the prominent role that this body plays in society, the researcher adopted the descriptive and analytical approach in carrying out this research, by collecting data from the departments and divisions staff of (160) respondents in an exclusively comprehensive

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Crossref
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Tue Dec 01 2015
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Journal Of Economics And Administrative Sciences
Strategic Training and its impact on The Performance of the inspectors General offices
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Publication Date
Mon Jul 21 2025
Journal Name
Magazine Aldhakwat Albedh
The impact of atheism on the individual and society, Iraq as a model
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Publication Date
Mon Jun 01 2015
Journal Name
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The phenomenon of negative behavior has studied as a social and psychological phenomenon that effect on the performance and life of workers inside and outside the organization. The adoption of this phenomenon is studied in terms of the role of the interna
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The phenomenon of negative behavior has studied as a social and psychological phenomenon that effect on the performance and life of workers inside and outside the organization. The adoption of this phenomenon is studied in terms of the role of the internal environment of the organization in addressing this behavior, being the variables belong to the field of organizational behavior to see the results of those variables on the Iraqi organizations, since the specificities of it differ from the rest of the Arab and foreign environments. Therefore, this study focused on testing the relationship of the internal environment of the organization and its role in addressing the negative behavior of the workers.

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Crossref
Publication Date
Sun Jun 23 2024
Journal Name
Asee Annual Conference And Exposition
Undergraduate Research Impact on Students' Retention and Academic Development Based on Their Study Field and the Mentoring Approach
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The impact of undergraduate research experiences on students' academic development and retention in STEM fields is significant. Students' success in STEM fields is based on developing strong research and critical thinking skills that make it essential for students to engage in research activities throughout their academic programs. This work evaluates the effectiveness of undergraduate research experiences with respect to its influence on student retention and academic development. The cases presented are based on years of experience implementing undergraduate research programs in various STEM fields at Colorado State University Pueblo (CSU Pueblo) funded by HSI STEM Grants. The study seeks to establish a correlation between students' reten

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Scopus
Publication Date
Sat Jul 01 2023
Journal Name
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Evaluation of the Antibiofilm Activity of Laurus nobilis Leaves Extract and Assessment of Its Effect on fimA and papC genes in Escherichia coli isolates
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