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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 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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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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The research dealt with the risks of reinsurance and its impact on the financial performance of the National Insurance Company by focusing on reinsurance in the marine insurance branch. Negative impact on the financial performance of the NICs and the Marine Insurance Branch. The research sample resulted in a main hypothesis that reflects this relationship. Lee in the analysis of financial information reports National Insurance Company of the branch of marine insurance for the period of 2010 until 2017, and the use of (retention) for measuring the re-insurance operations index, and (insurance financial surplus rate) to measure financial performance. For the purpose of obtaining the results, a number of statistical methods were used accord

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Publication Date
Fri Sep 01 2023
Journal Name
Iraqi Journal Of Physics
Influence of NiTi Spring Dimensions and Temperature on the Actuator Properties
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Nitinol (NiTi) is used in many medical applications, including hard tissue replacements, because of its suitable characteristics, including a close elastic modulus to that of bones. Due to the great importance of the mechanical properties of this material in tissue replacements, this work aims to study the hysteresis response in an attempt to explore the ability of the material to remember its previous mechanical state in addition to its ability to withstand stress and to obtain the optimal dimensions and specifications for the manufacturer of NiTi actuators. Stress-strain examination is done in a computational way using a mutable Lagoudas MATLAB code for various coil radii, environment temperatures, and coil lengths. The computational m

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Publication Date
Sun Aug 02 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of cigarette smoking on salivary IgA and periodontal disease
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Background: Chronic periodontitis is an inflammatory disease of tissues supporting the teeth. Salivary compositions have been most intensely studied as a potential marker for periodontal disease. In this study, analysis of saliva provides a simple and non-invasive method of evaluating the role of salivary IgA (s-IgA) levels in periodontal disease by detecting the level of (s-IgA) in patients with chronic periodontitis smokers and non smokers patients and correlate the mean (s-IgA) levels with clinical periodontal parameters Plaque index (PLI) gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL). Materials and Methods: The study samples consists of (15) patients with chronic periodontitis who were non smokers (

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effect of Brucellosis on Lipid Profile and Oxidant-Antioxidants Status
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The activation of inflammatory cells, the release of their mediators, and the excessive production of free radicals may affect circulating lipids, but no evidence supports a role for peroxidation in the pathogenesis of Brucellosis disease. The aim of this work is to study the effect of Brucellosis on lipid profile concentration and oxidant-antioxidant status. We studied 20 Brucellosis patients (18 Females and 2 males) and 15 healthy controls (age average from 16 to 60 years old). Significant differences were noted between the serum lipids of Brucellosis patients and control group. Mean total cholesterol and low density lipoprotein cholesterol (LDL-cholesterol) concentrations were higher in patients than in control group (mean ± SE 197

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Advanced Pharmacy Education And Research
The effect of formulation and process variables on prepared etoricoxib ‎Nanosponges
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Sun Jan 01 2023
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Publication Date
Sun Aug 02 2026
Journal Name
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The Effect of Preservatives and Freezing on Museum Saved Fish Samples
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Two means used for saving fish samples, namely Freezing and Preservatives represented by Alcohol and Formalin. The Freezing was used in saving samples collected newly, in addition to use Alcohol and Formalin with different concentrations 70% of Alcohol and 10% of Formalin. The concentrations of some heavy metal elements were examined, such as Potassium, Phosphorus, Calcium, Manganese, Magnesium, Zinc, Iron, Copper and Boron in samples saved in Formalin and Alcohol and frozen at different durations. The concentration of some elements has been changed during the saving duration. The study was performed on the concentration of heavy elements in the Liza abu muscles of saved and frozen fish.

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Publication Date
Sat Aug 31 2019
Journal Name
Iraqi Journal Of Physics
Investigate Salts type and concentration on the conductivity of Polymer Electrolyte
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Polymer electrolytes systems compose of (PEO+KI+I2) and (PEO+RbI+I2) with different concentration, and a fixed amount of ethylene carbonate (EC) and propylene carbonate (PC) over temperatures range 293-343 K prepared by solution cast me

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Physical Environment and Crowded Classes on Academic Achievement
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The research problem can be summarized through focusing on the environment that surrounds students and class congestion, how these factors affect directly or indirectly the academic achievement of students, how these factors affect understanding the scientific material that the student receives in this physical environment, how classroom’s components such as seats, space With which the student can move, the number of students in the same class,  the lighting, whether natural or artificial, and is this lighting sufficient or not enough, the nature of the wall paint old or modern, is it comfortable for sight, the blackboard if it is Good or exhausted,  In addition to air-conditioning sets in summer and winter, this is on the on

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