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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
Wed May 01 2013
Journal Name
Chemical And Process Engineering Research
Synthesis and Characterization of Polycyclicacetal Derived from PEG & Erythro-Ascorbic Acid Derivative and Study Its Effect on the Activity of ACh Enzyme (In Vitro)
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Polycyclicacetal was prepared from the reaction of PEG with aldehyde derived from Erythro-ascorbic acid (pentulosono-ɣ-lactone-2,3-enedianisoate).All these compounds were characterized by Thin Layer Chromatography (TLC) and FTIR spectra and aldehyde was also characterized by (U.V-Vis), 1HNMR, 13CNMR, and mass spectra.The inhibitory effect of prepared polymer on the activity of human serum AcetylCholinesterase has been studied in vitro. The polymer showed a remarkable activity at low concentration (4.7x10-3 – 4.7x10-8M).

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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  .

The second transits series(DM97,MM5,DM96,DF115) respectively were  represented P5 , P6 , P7 , P8  .The third  transits series(DM46,MMg,MF12,MM11) re

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Publication Date
Tue Nov 18 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
Tue Nov 18 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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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The objective Effect of Internal and External Environment and its Psychological & Practical Reflection on the Political Decision-Making Process
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The objective Effect of Internal and External Environment and its Psychological & Practical Reflection on the Political Decision-Making Process

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Analysis of the rebound effect and interactive between fiscal and monetary policy on the General economic equilibrium (IS-LM)
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      Will address this research interaction and coordination between fiscal and monetary policies and the impact of this interaction and coordination on economic stability and growth، and how the financial implications of monetary policy may stimulate action monetary policy and treatment side effects and the nature of responsiveness and bounce between procedures both two policies and their impact on the balance of overall economic and explained in the folds of searchjustifications coordination and the extent necessary in order to address the imbalances in economic activity through twinning actions of monetary and fiscal، has embodied this coordination and interaction between policies and their impact m

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of marketing tools on the legal liquidity index : an applied research in the International Development Bank for Investment and Finance
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Abstract

               The main problem of the study lies in the lack of a clear perception among the study sample about the impact of digital marketing tools on legal liquidity. Legal) of the International Development Bank for Investment and Finance and to achieve the objectives of the research, the method of observation and survey was used in measuring the dimensions of digital marketing. As for banking liquidity, the reports and financial statements of the bank were used as the research sample, as well as the use of the statistical analysis program SPSS in the statement of the relationship The study concluded, in summary, the following: Mar

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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
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
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Controller work specificity and their impact on performance (Applied Study in the financial oversight bodies)
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The research aims to a statement of specificity of the Controller of (academic achievement, specialty, job title, length of service, Gender) and its impact on performance, Through a proposed appraisal form includes three main axes and each axis including several specialized elements in the supervisory work in form (check list). as is the importance of research to enable officials of oversight bodies financial identify and diagnose performance Controller through what has this observer of the process of scientific properties when performing supervisory work. Be summarized problem of the research that the lack of regulatory institution with the Controller interesting in terms of the necessary characteristics and requirements and inv

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