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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 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Credit Structure Patterns And Their Reflection In The Value Bank Applied Research on a Sample of the Iraqi Private Banks
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The study seeks to determine the levels of credit structure (independent variable) depending on its components (loans, credit disseminate, other facilities) To get the eight patterns of the structure of bank credit for the purpose of assessing the relationship between changes in levels of each style of structure credit (increase or decrease) and reflected in maximizing the value of the Bank(The adopted a measured variable depending on the approximate equation of simple Tobin's Q) to determine the style that achieves the highest value of the Bank, to take advantage of it in management, planning and control by knowing the strengths and weaknesses of the historical distribution of the facilities . the sample of the

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Reinsurance risks and their reflex on the financial performance of the National Insurance Company: Applied Research in Maritime Insurance Branch
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Publication Date
Sun Mar 13 2011
Journal Name
Baghdad Science Journal
The Effect of Silybum marianum L. aquatic crude extracts on the cancer cell lines and normal cell line in vitro
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The aquatic crude extract of Silybum marianum dry grains prepared by melting them in distil water by the method of soak and shake. The effect of Silybum marianum crude extract studied in vitro on three tumor cell line the Hep-2, AMN-3 and RD for 24, 48 and 72 hours of exposure, and one cell line of normal cells REF for 72 hr exposure. The results showed that the prescence of toxic effect of the aquatic crude extract on the cell lines of Hep-2, AMN-3 and RD at 10 and 100 µg/ ml upto the higher concentrations when they exposed to the extract for 48 hr. as compared with the control treatment, and when the exposure period increased to 72 hr. the toxic effect started at low concentrations (5 and 10 µg/ ml) as compared with the control g

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Sun Jan 01 2023
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Dental Hypotheses
Assessment of the Impact of Adhesive and Wires Types on the Tensile Bond Strength of Fixed Lingual Retainers Used in Orthodontics: An In Vitro Study
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Publication Date
Tue Nov 18 2025
Journal Name
Revista Iberoamericana De Psicología Del Ejercicio Y El Deporte, Issn 1886-8576, Vol. 18, Nº. 3, 2023, Págs. 319-323
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Autorías: Wafaa Sabah Mohammed Al-Khafaji, Fatimah Hameed Kzar Al-Masoodi, Suadad Ibrahim Suhail Al-Kinani. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 3, 2023. Artículo de Revista en Dialnet.

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Publication Date
Sun Nov 20 2022
Journal Name
Journal Of New Zealand Studies
The Impacts of Environmental-Geomorphology of the Kut Barrage on the Tigris Waterway and the Neighboring regions
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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Screening Program for Idiopathic Scoliosis by Adam's Bending Forward Test of Prepubertal Children at Primary Schools in Baghdad City
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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Impact of Education Program upon Nurses' Knowledge towards Children under Mechanical Ventilation at Pediatric Teaching Hospitals in Baghdad City
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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
“The impact of the critical factors for the transfer of knowledge on opportunities and strategic success”
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Publication Date
Thu Jun 30 2022
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
The effect of soaking and wetting on the properties of the gypsum soil treated with polyurethane
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the shear strength parameters of the treated and untreated gypsum soil under the effect of four soaking and drying cycles has studied in this paper, moreover examined the effect of wetting and drying cycles on the collapse potential of the soil and comparing between the behavior of the treated and untreated gypsum soil under the effect of the two conditions. Gypsum soil sample brought from Sawa lake in Al Muthana governorate with the content of gypsum 65.5%, the polyurethane polymer (PP) was used with different percentages 3, 6, and 10% to enhance the mechanical properties of gypsum soil, model was prepared to achieve four soaking and drying cycle to the samples before testing, this model consists of an Aluminum plate base with dimensions 7

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