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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
Sun Jul 21 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Assessment of the Knowledge and Practice on Safe Handling of Anticancer Drugs among Pharmacists in Iraqi Healthcare Settings
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Background: Occupational exposure to hazardous drugs occurs in all aspects of anticancer drug handling. Proper recommendations and guidelines should be applied to control and reduce exposure. Objective: To assess pharmacists' knowledge and practice regarding the safe handling of anticancer drugs. Methods: A cross-sectional study was conducted at seven major hospitals in Baghdad City, Iraq, from December 2023 to February 2024. A pre-designed questionnaire was given to pharmacists who handled anticancer drugs in chemotherapy units. The questionnaire comprises sociodemographic data, knowledge of the safe handling of cytotoxic drugs and thoughts about exposure and risk, practices for safely handling cytotoxic drugs, and challenges for s

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Publication Date
Sat Apr 25 2020
Journal Name
International Journal Of Research In Social Sciences And Humanities
THE EFFECT OF CAPITAL ADEQUACY AND ASSET QUALITY ON THE VALUE OF THE BANK AN APPLIED STUDY ON A SAMPLE OF IRAQI BANKS LISTED ON THE IRAQ STOCK EXCHANGE
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As the banking sector is a strong influence on the country's economic growth,The solid financial well-being of anybank does not mean only a guarantee for its investors, It is also important for both owners and workers and for theeconomy in all its joints.The elements of capital adequacy and quality of assets are important to the functioning of thebanking business.In this study, the research sample included four private banks. Quarterly data were used for the period(2011 - 2018).Moreover, data is also collected from articles, papers, the World Wide Web (the Internet) and specializedinternational journals.In this research, an effort was made to try to find out the effect of (the ratio of the capital owned todeposits on the value of the bank),

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Publication Date
Sun Mar 05 2017
Journal Name
Baghdad Science Journal
Positive and Negative Aspects of Copaxone ( Glatiramer acetate) Action on TC, TG HbA1c and Iron Levels in The Sera of Iraqi Women with Multiple Sclerosis in Baghdad
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Publication Date
Mon Dec 20 2021
Journal Name
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STUDY THE PHYSICAL AND CHEMICAL PROPERTIES AND DETERMINATION THE CYTOTOXICITY OF KOJIC ACID PRODUCED FROM THE LOCAL ISOLATE ASPERGILLUS FLAVUS WJF81 AND THEIR EFFECTS ON CONSUMER HEALTH.: STUDY THE PHYSICAL AND CHEMICAL PROPERTIES AND DETERMINATION THE CYTOTOXICITY OF KOJIC ACID PRODUCED FROM THE LOCAL ISOLATE ASPERGILLUS FLAVUS WJF81 AND THEIR EFFECTS ON CONSUMER HEALTH.
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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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Publication Date
Sat Feb 21 2026
Journal Name
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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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Publication Date
Thu Sep 30 2021
Journal Name
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Publication Date
Sat Feb 21 2026
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
Sun Dec 07 2014
Journal Name
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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
Sun Oct 07 2012
Journal Name
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