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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
Thu Oct 02 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of various endodontic irrigants on the sealing ability of Biodentine and other root perforation repair materials (In vitro study)
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Background: This in vitro study was carried out to evaluate the effect of various endodontic irrigants (sodium hypochlorite, ethylene diaminetetracetic acid and normal saline) on sealing ability of (Biodentine, mineral trioxide aggregate, and amalgam) used to repair furcal perforations. Material and methods: One hundred and twenty extracted human molars with divergent roots were used in this study. A standard root canal access cavity was prepared in each tooth and furcal perforation was made and was standardized by using k file size 100 instrument to get a perforation of (1.32mm) in diameter .The teeth were randomly divided in to three groups of 40 teeth according to the type of material used to repair the perforations (Group A: The furcal

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
The impact of The Bransford and Stein Model on the Achievement of Fifth-Grade Literary Students for Geography and their Reflective Thinking
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The current research aims to identify the effect of the Bransford and Stein model on the achievement of fifth-grade literary students for geography and their reflective thinking. To achieve the objective of the research, the following two null hypotheses were formulated:

  • There is no statistically significant difference at the significance level (0.05) between the average scores of the experimental group students who studied geography using the Bransford and Stein model and the average scores of the control group students who studied the same subject in the usual way in the achievement test. 2- There is no statistically significant difference at the significance level (0.05) between the average scores of the experimental gr

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Publication Date
Thu Jan 25 2024
Journal Name
Iraqi Journal Of Agricultural Sciences
EFFECTS OF MINERAL FERTILIZATION AND SPRAYING WITH SALICYLIC ACID AND AMINO ACIDS ON THE GROWTH AND PRODUCTIVITY OF INDUSTRIAL POTATOES
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This experiment was carried out at a private field in the eastern Radwaniyah Baghdad for the fall season 2020/2021 and spring 2021 to study the effects of adding mineral fertilizers, spraying salicylic acid and amino acids on some growth traits and yield of industrial potato plants. 200 kg N h-1 , 100 kg P2O5 h-1, 100 kg K2O h-1 and F2 consist of 275 kg N h-1, 180 kg P2O5 h-1, 200 K2O h-1 and F3 consist of 350 kg N h-1, 360 kg P2O5 h-1, 300 K2O h-1 and salicylic acid in three concentrations of 0,50 and 100 mg L-1 ( S1, S2, S3) and amino acids in three concentrations of 0, 1.25 and 2.5 ml L-1 ( A1, A2 , A3) It was carried out as a factorial split plot experiment, where the fertilizer levels (F1, F2 and F3) are in the main plot and th

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Publication Date
Sun Oct 07 2012
Journal Name
Journal Of Educational And Psychological Researches
The Effect of KWL Strategy on the Achievement of the Students of the fourth class literary in the subject of History and the Development of Cognitive Thinking skills
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Whereas conventional methods of teaching history do not meet the sometimes purpose has suggested some educators strategies modern help to improve the level of students in the education process through activating prior knowledge and employed in positions of current learning, and focus attention on the points and the outstanding elements of the content and practice techniques Calendar criticof ideas and meanings and mental and linguistic activities used to verify the extent of reaching understanding.                                       &n

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Publication Date
Wed Apr 10 2013
Journal Name
Journal Of The College Of Basic Education
Effect of heavy metal ions copper, cadmium and cobalt on the growth and reproduction of the aquatic fungus Saprolegnia hypogyna.
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The current study aimed to evaluate the effect of the heavy metals copper, cadmium and cobalt when added individually, in combination and in combination on the growth and reproduction of the aquatic fungus Saprolegnia hypogyna.

Publication Date
Wed Jun 01 2022
Journal Name
Journal Of Sport Science Technology And Physical Activities
The effect of using Daniel's model and Driver’s model in learning a kinetic chain on the uneven bars in the artistic gymnastics for female students
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The aim of this study to identity using Daniel's model and Driver’s model in learning a kinetic chain on the uneven bars in the artistic gymnastics for female students. The researchers used the experimental method to design equivalent groups with a preand post-test, and the research community was identified with the students of the third stage in the college for the academic year 2020-2021 .The subject was, (3) class were randomly selected, so (30) students distributed into (3) groups). has been conducted pretesting after implementation of the curriculum for (4) weeks and used the statistical bag of social sciences(SPSS)to process the results of the research and a set of conclusions was reached, the most important of which is t

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Publication Date
Fri Jan 01 2021
Journal Name
Psychology And Education
The effect of Daniel's model on the development of critical thinking in the subject of Arabic language among students of the College of Management and Economics
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This research aims to identify the impact of Daniel's model on the development of critical thinking. In order to achieve this objective, the following hypotheses are formulated: 1. There is no statistically significant difference at the significance level (0.05) between the average differences in the posttest scores of the experimental group taught according to Daniel's model and the control group taught according to the traditional method in the measure of critical thinking. 2. There is no statistically significant difference at the significance level (0.05) between the average differences in the preand post-tests scores of the experimental group taught according to Daniel's model in the measure of critical thinking. The current research i

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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The strategic recovery of the insurance service and its reflection on achieving the strategic goals: research My application in the National Insurance Company
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The research topic dealt with the strategic recovery of the insurance service, which is one of the approaches that have an important role in providing solutions and remedies for the recession that affects companies and hinders them from achieving their strategic goals. The research also addressed the strategic objectives of the company as the rationale and actual guide for companies of all activities in order to protect their systems from deviation for its desired purpose. So the aim of the research is to demonstrate the repercussions of the strategic recovery of the insurance Service represented by (compensation, speed of response, apology, initiative (identifying the problem). The company's strategic goals are represented (prof

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Publication Date
Sun Dec 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Oral health in relation to nutritional status among 10 years old primary school children in Al-Hillah city/ Iraq
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Background: Oral health and nutrition are in interdependent relationship that good nutritional health enhancing good oral health. Nutrition can affect the development and integrity of oral cavity and the progression of oral disease. The aim of the present study was to assess the prevalence of the gingival health condition in relation to the nutritional status, among 10 years old primary school children in urban and rural area in Al-Hillah city. Material and method: Eight hundred ninety one (891) students, aged10 years old, selected randomly from different primary schools, in urban and rural area in Al-Hillah city, were included in this study. Oral examination including of plaque index assessment, which was done according to the criteria

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Publication Date
Tue Sep 01 2015
Journal Name
Journal Of Engineering
Experimental Study on the Effect of Using Metallic Brushes on the Charging and Discharging Time of Thermal Energy Storage Unit
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Phase change materials are known to be good in use in latent heat thermal energy storage (LHTES) systems, but one of their drawbacks is the slow melting and solidification processes. So that, in this work, enhancing heat transfer of phase change material is studied experimentally for in charging and discharging processes by the addition of high thermal conductive material such as copper in the form of brushes, which were added in both PCM and air sides. The additions of brushes have been carried out with different void fractions (97%, 94% and 90%) and the effect of four different air velocities was tested. The results indicate that the minimum brush void fraction gave the maximum heat transfer in PCM and reduced the time

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