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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 Dec 31 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The efficiency of the tax examiner and its impact on reducing the risk of tax evasion
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The research dealt with the effect of the tax examiner's efficiency in detecting tax evasion, as the research problem dealt with tax evasion, especially in Iraq, for many reasons and factors, including those related to tax administration represented in administrative corruption and the complexity of procedures in the tax accounting process and failure to achieve justice in the tax treatment, including the taxpayer himself, as he tries to evade for reasons Related to the level of tax awareness, loss of confidence in the tax administration, and reasons related to the state's inability to manage the services file well and its ability to achieve the set goals, This reflected negatively on the emergence of some of the consequences of

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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
Loqmania commandments in the Koran And its impact in the refinement of the doctrine and morals emerging
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Luqman's story stated that human instinct, if I was brought up properly, reaches wisdom and inflicts the right to everything. It is to go to worship God and adhere to the satisfaction of morals and high morals that are ordered to meet among human beings in this life, because this worship educates in the soul the most beautiful morals needed by human beings of honesty, honesty and modesty, and the work of good and virtues, and distancing the soul from evil and vices.

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Publication Date
Wed Jul 23 2025
Journal Name
Journal Of Babylon Center For Humanities Studies
The motives of pain in the play (Bells and Trains) by Yehuda Amichai
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The upbringing of Yehuda Amichai and the conditions he lived in had a great influence on his deep sense of pain, which made him think of death and suicide. Especially after the Nazis came to power in Germany, and his emigration with his family. Amichai searched for love throughout his life, and his failure was one of the most important factors affecting his psyche, which is A deep influence that made him live in harsh and painful pains that broke him, and prevented her from achieving his ambitions in life.Dramatic texts are characterized by repetition in writing and presentation. It is a textual discourse that has two advantages, first, that it can be read as a literary text like all other literary texts, and second, that it can be consider

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Wed Jul 23 2025
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Mustansiriya Medical Journal
Dermatological Diseases among children Attending Al-Yarmouk Teaching Hospital-Outpatient Department of Dermatology
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Publication Date
Sat Jun 06 2020
Journal Name
Journal Of The College Of Education For Women
Spatial Analysis of Soil Characteristics and its Effect on Determining the Susceptibility of lands of the RasheedRegion: A Study in Soil Geography
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Twelve pends were selected and distributed on three verticals transects paths on the Tigers river in Al Rasheed county.Passing through land covers, that classified and covers the whole region. Based on the 8 Landsat of the year 2015. It was oriental classified by using Erdas 10.2 . The pedons were distributed on the area of each varicty of these classes. the series of soil according of the transect series (DW74,MMg,DMu6 , Df96) respectively were represented P1 , P2 , P3 , P4  .

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Publication Date
Wed Jul 23 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of curvature angle and rotational speed on the cyclic fatigue of three types of rotary instrument (In vitro): comparative study
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Background: The fracture of instruments within root canal during endodontic treatment is a common incidence, fracture because of fatigue through flexure occurs due to metal fatigue, this study aimed to assess the effect of curvature angle and rotational speed on the cyclic fatigue of different type of Endodontic NiTi Rotary Instruments and compare among them. Materials and method: Three types of rotary instruments with tip size 0.25: ProTaPer F2 (Densply, Malifier) Revo-S SU( 0.06 taper, MicroMega) and RaCe system (0.06 taper, FKG, Dentaire), Forty file of each instrument were used within two canals with angle of curvature (40 &60 )at two speed (250&400)RPM, twelve group were formed for all instruments(total number=120),ten file fo

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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
The impact of public expenditure and public revenue on some of the intangible components of social development in Iraq for the period 1985-2008
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تحتل أدوات السياسة المالية (الإنفاقية والإيرادية) مكانة مهمة بين أدوات السياسات الاقتصادية الأخرى لما تتمتع به من تأثيرات اقتصادية واجتماعية على مجمل النشاط الاقتصادي .

     وفي بحثنا هذا سنركز على الآثار الاجتماعية لأدوات السياسة المالية (الإنفاق العام والإيراد العام) لما للتنمية الاجتماعية من أهمية متزايدة في عالمنا اليوم خاصة فيما يتعلق بمقوماتها غير المادية المتمثلة في خدما

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Publication Date
Fri Dec 29 2023
Journal Name
International Journal Of Nanoscience
Detection of Silica in Rice Husks Using Laser-Induced Plasma and Studying the Effect of Laser Energy on the Parameters of the Produced Plasma
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This study aims to analyze the spectral properties of plasma produced from rice husk(Rh) using the laser breakdown spectroscopy (LIBS) method. The plasma generation process used the fundamental harmonic (1064 nm) of a Q-switched Nd:YAG laser. Yttrium aluminum garnet (YAG) is a man-made crystalline material. The laser fired pulses with a duration of 10 ns and a repetition rate of 6 Hz. Thus, the energy outputs achieved were 50–200 mJ at the wavelength of 1064 (nm). The silica content in the rice hulls was verified using an XRF measurement, which revealed the presence of silica in the rice hulls in a high percentage. Precise beam focusing was achieved by focusing the laser on the target material. This target material is placed with

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Publication Date
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Temperature on the Stability and Release Profile of Ibuprofen Microcapsules
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The stability and releasing profile of 2:1 core: wall ratio ibuprofen microcapsules prepared by aqueous coacervation (gelatin and acacia polymers coat) and an organic coacervation methods (ethyl cellulose and sodium alginate polymers coat) in weight equivalent to 300mg drug, were studied using different storage temperatures 40°C, 50°C ,60°C and refrigerator temperature 4°C in an opened and closed container for three months (releasing profile) and four months (stability study).It was found that, these ibuprofen microcapsules were stable with expiration dates of 4.1 and 3.1 years for aqueous and an organic method respectively.Aqueous prepared ibuprofen microcapsules were found more stable than those microcapsules prepared by or

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Publication Date
Mon Jun 30 2008
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Effect of Ageing on Physical and Chemical Properties of Asphalt Cement
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Two grades of paving asphalt with penetration of 46 and 65 are studied for determining changes in their physical and chemical properties caused by ageing.
The ageing process has been conducted on two petroleum paving asphalt cement using thin film oven test at 150, 163 and 175 C, and ageing time 5, 10,15, 20, 25 and 30 hours. The effect of ageing time and temperature on penetration, kinematic viscosity, softening point, solubility in trichloroethylene, heat loss and changes in chemical composition are investigated. The results of thin film oven test process indicte that the asphaltenes concentration of all aged asphalt increases with increasing ageing time, while the opposite was observed for polar-aromatic and naphthene-aromatic. The

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