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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
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Office managers skills and it's impact on the effectiveness of time management A survey of a sample of departments managers in the institutes and faculties at the middle technical university
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The objective of this study is to highlight the skills of office managers and it's impact on the effectiveness of time management in the institutes and faculties of middle technical university and a group of cognitive and practical aims. The managers skills forms mthe modern trend and the main source to provide organizations with highly skilled managers with distinctive performance and because of the sharp changes in the environment which today's organizations works in it , business organizations generally and managers especially realise the importance of time management and it's role in achieving competitive advantage . The problem of this study raised from this point which reflect the extent of departments managers realisation

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Publication Date
Wed Jan 11 2023
Journal Name
College Of Islamic Sciences
The jurisprudential aspects of Imam Abu al-Fayyadh al-Basri And its impact on the Shafi’i school of thought, In the provisions of transactions, personal status, felonies, borders, and others
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Summary of the discussion of the jurisprudential aspects of Imam Abu Al-Fayyad Al-Basri, and their impact on the Shafi’i school, on the provisions of transactions, personal status, janaabah, limits, and others

      Praise be to God, Lord of the Worlds, and prayers and peace be upon the Master of the Messengers, our master Muhammad, and upon his pure family, and his ignorant and ignorant companions, and those who followed them in goodness until the Day of Judgment.

     Then:

     The many jurisprudential aspects that the Shafi’i imams said are of great importance, because these aspects are nothing but the opinions of venerable jurists who have reached a high degree of knowledge unti

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Publication Date
Sun Jul 01 2018
Journal Name
Journal Of Educational And Psychological Researches
Slums and its implication on security in Baghdad
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The research team seeks to study the phenomena of random housing in Iraqi society in general and Baghdad city in particular by standing on the causes behind this phenomena and its relation with security situation in Baghdad. The researchers adopted a theoretical and practical framework. The main objective is to diagnose the risks caused by the escalation of slums in Baghdad city. 

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Some Thoughts on Greetings in English and Arabic
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The present study examines the main points of differences in the subject of greetings between the English language and the Arabic language. From the review of the related literature on greetings in both languages, it is found that Arabic greeting formulas are more elaborate than the English greetings, because of the differences in the social customs and the Arabic traditions and the Arabic culture. It is also found that Arabic greetings carry a religious meaning basing on the Islamic principle of “the same or more so”, which might lead to untranslatable loopholes when rendered in English.

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Publication Date
Fri Feb 20 2026
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
Journal Name
Special Exercises For Offensive Tactical Skills And Their Impact On Developing The Speed And Accuracy Of Some Basic Skills In Youth Football
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
Thu Dec 31 2020
Journal Name
Political Sciences Journal
The Trade War Between the United States and China and Its Impact On the World Economy2017-2019
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The trade war, of course, leads to a sharp tension in international relations because the economy is the lifeblood of the states. In the world of trade and economy, countries began to lean towards cooperation. Economic relations after World War II were more liberal, trade barriers were removed and global trade became more flexible and smooth

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Publication Date
Fri Feb 20 2026
Journal Name
Magazine Aldhakwat Albedh
The impact of atheism on the individual and society, Iraq as a model
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Atheists have spread in the modern era, so that atheism has become a bad phenomenon in the world in general and in Islamic societies in particular, so the research aims to study the individual and social effects left by atheism on the atheists themselves, and the research included multiple axes: atheism linguistically and idiomatically, atheism in the Qur’an Noble and Modern (and Contemporary) Atheism Statistics: and the reasons for atheism: Studying the phenomenon of atheism in Iraq as a model, then studying the effects of atheism: on the individual first, then atheism and its impact on society, then the conclusion, recommendations, sources and references

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Strategic Training and its impact on The Performance of the inspectors General offices
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The research aims  to study strategic training and its impact on improving the performance of the inspectors general offices in Iraqi ministries, through two variables strategic training Which include Four Dimensions ( Strategic analysis , Formulation of Training Strategy , Implement the Training Strategy , Evaluation ) and Performance included Three dimensions ( Efficiency , Effectiveness , Added-Value).

This research problem is that the Offices of Inspectors rely on pre-made training Programs  received from training centers without designing the training programs that provide the employees with the skills and abilities that lead to the implementation of the current and future goals of the orga

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