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bijps-974
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 Oct 01 2018
Journal Name
Journal Of Craniofacial Surgery
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Publication Date
Fri Jan 08 2010
Journal Name
Al-kindy College Medical Journal
Maternal and fetal outcomes in emergency versus elective two or more previous cesarean deliveries
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Publication Date
Wed Jun 30 2010
Journal Name
Al-kindy College Medical Journal
MATERNAL AND FETAL OUTCOMES IN EMERGENCY VERSUS ELECTIVE TWO OR MORE PREVIOUS CAESAREAN DELIVERIES
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Background: Women with previous two or
more caesarean deliveries are usually
managed by elective cesarean section to avoid
the possible risks of labor.
Objective: To compare the relative risks of
maternal and fetal outcomes in emergency
versus elective previous two or more
caesarean deliveries
Design: Randomized prospective clinical
study
Setting: Al-Elweya Maternity Teaching
Hospital, from 1st of March to 31st of
September 2008.
Methods: The study groups, those who had
previous two or more caesarean deliveries,
were included from the hospital admissions.
The 1st group (102 women) presented in labor
and was managed by caesarean delivery as
soon as it was possible. The second group (7

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Thu Jul 06 2017
Journal Name
Al-mustansiriyah Journal Of Science
Modification the ELISA Kit for diagnosis of Psedudomonas aeruginosa and comparing its with ordinary ELSA Kit
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Wed Aug 30 2023
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Publication Date
Fri Jun 16 2023
Journal Name
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Sun Apr 30 2023
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The Surgical outcomes of fundus-first technique in lowering the rate of bile duct injuries and bleeding during open cholecystectomy that facing intraoperative difficulties: A single-center prospective study: The surgical outcomes of open fundus-first cholecystectomy technique.
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Background: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.

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Publication Date
Sat Jul 26 2025
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Metabolic Syndrome; Comparing the Results of Three Definition Criteria in an Iraqi Sample
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Background: Different diagnostic definition and criteria have been recommended by different expert groups for the diagnosis of metabolic syndrome, however, it’s prevalence in the same population could differ depending on the definition used yielding different results. In Iraq, there is a lack of research comparing these different diagnostic definitions.

Objective: To find out the most suitable metabolic syndrome definition to be used for Iraqi people.

 Methods: 320 participants were recruited for this study, 53.4% men and 46.6% women, aged between 25-85 years, visiting Baghdad Teaching Hospital, the prevalence of metabolic syndrome according to different definition

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Mon Jan 01 2018
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Metabolic Syndrome; Comparing the Results of Three Definition Criteria in an Iraqi Sample
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Background: Different diagnostic definition and criteria have been recommended by different expert groups for the diagnosis of metabolic syndrome, however, it’s prevalence in the same population could differ depending on the definition used yielding different results. In Iraq, there is a lack of research comparing these different diagnostic definitions. Objective: To find out the most suitable metabolic syndrome definition to be used for Iraqi people.  Methods: 320 participants were recruited for this study, 53.4% men and 46.6% women, aged between 25-85 years, visiting Baghdad Teaching Hospital, the prevalence of metabolic syndrome according to different definitions were compared and the agreement was assessed by the Kappa st

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