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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 Jan 01 2021
Journal Name
Journal Of Advanced Pharmacy Education And Research
The effect of formulation and process variables on prepared etoricoxib ‎Nanosponges
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Publication Date
Thu Oct 02 2025
Journal Name
Advances In Life Science And Technology
The Effect of Preservatives and Freezing on Museum Saved Fish Samples
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Two means used for saving fish samples, namely Freezing and Preservatives represented by Alcohol and Formalin. The Freezing was used in saving samples collected newly, in addition to use Alcohol and Formalin with different concentrations 70% of Alcohol and 10% of Formalin. The concentrations of some heavy metal elements were examined, such as Potassium, Phosphorus, Calcium, Manganese, Magnesium, Zinc, Iron, Copper and Boron in samples saved in Formalin and Alcohol and frozen at different durations. The concentration of some elements has been changed during the saving duration. The study was performed on the concentration of heavy elements in the Liza abu muscles of saved and frozen fish.

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Publication Date
Thu Oct 02 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of cigarette smoking on salivary IgA and periodontal disease
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Background: Chronic periodontitis is an inflammatory disease of tissues supporting the teeth. Salivary compositions have been most intensely studied as a potential marker for periodontal disease. In this study, analysis of saliva provides a simple and non-invasive method of evaluating the role of salivary IgA (s-IgA) levels in periodontal disease by detecting the level of (s-IgA) in patients with chronic periodontitis smokers and non smokers patients and correlate the mean (s-IgA) levels with clinical periodontal parameters Plaque index (PLI) gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL). Materials and Methods: The study samples consists of (15) patients with chronic periodontitis who were non smokers (

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Physical Environment and Crowded Classes on Academic Achievement
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The research problem can be summarized through focusing on the environment that surrounds students and class congestion, how these factors affect directly or indirectly the academic achievement of students, how these factors affect understanding the scientific material that the student receives in this physical environment, how classroom’s components such as seats, space With which the student can move, the number of students in the same class,  the lighting, whether natural or artificial, and is this lighting sufficient or not enough, the nature of the wall paint old or modern, is it comfortable for sight, the blackboard if it is Good or exhausted,  In addition to air-conditioning sets in summer and winter, this is on the on

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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Effect of measurement and analysis of quality costs on continuous improvement: Applied research in the Directorate General for the distribution of electric power in the Middle Euphrates
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Publication Date
Sat May 01 2021
Journal Name
Journal Of Engineering
Impact of the Weir Slit Location, the Flow Intensity and the Bed Sand on the Scouring Area and Depth at the Dam Upstream
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A total of 48 experiments were conducted to investigate the impact of slit weir dimensions and locations on the maximum scour depth and scour area created upstream. The slit weir model was a 110 mm slit opening, and it was installed at the end of the working section in a laboratory flume. The flume was 10.0 m long, 30 cm wide, 30 cm deep, and almost middle. It includes a 2 m working section with a mobile bed with 110 mm in thickness. In the mobile bed, two types of nonuniform sand (with a geometric standard deviation of 1.58 and 1.6) were tested separately. The weir dimensions and location were changed with flow rates. Then dimensions of the slit weir were changed from 60 x 110 mm to 60 x 70 mm (width x height), while th

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Publication Date
Thu Oct 02 2025
Journal Name
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The Influence of Different Fabrication Techniques and Preparation Designs on the Marginal Adaptation of Ceramic Veneers (An In vitro Comparative Study)
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Background: Ceramic veneers represent the treatment of choice in minimally invasive esthetic dentistry; one of the critical factors in their long term success is marginal adaptation. The aim of the present study is to evaluate the marginal gap of ceramic veneers by using two different fabrication techniques and two different designs of preparation. Material and methods: A typodont maxillary central incisor used in the preparation from which metal dies were fabricated, which were in turn used to make forty stone dies. The dies divided into four experimental groups, each group had ten samples: A1: prepared with butt-joint incisal reduction and restored with IPS e.max CAD, A2: prepared with overlapped incisal reduction and restored with IPS e.

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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
The Influence of Different Fabrication and Impression Techniques on the Marginal Adaptation of Lithium Disilicate Crowns (A comparative in vitro study)
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Background: The marginal adaptation has a key role in the success and longevity of the fixed dental restoration, which is affected by the impression and the fabrication techniques .The objective of this in vitro study was to evaluate and compare the marginal fitness of lithium disilicate crowns using two different digital impression techniques (direct and indirect techniques) and two different fabrication techniques (CAD/CAM and Press techniques). Materials and Methods: Thirty two sound upper first premolar teeth of comparable size extracted for orthodontic reason were selected in this study .Standardized preparation of all teeth samples were carried out with modified dental surveyor to receive all ceramic crown restoration with 1 mm deep

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Publication Date
Sun Dec 07 2014
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The effect of different doses levels of silver nanoparticles (AgNPs) on the kidney and liver in Albino male Rat. Histopathological study
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Publication Date
Thu Sep 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
Human Resource Management and its Impact on the Level of Job Performance: An Analytical Research in the Iraqi Ministry of Interior
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