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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 Feb 22 2026
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 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
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
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
Sun Mar 01 2015
Journal Name
Baghdad Science Journal
The Effect of Age and Gender on Fetuin-A and Some Biochemical parameters in Blood Sera of Iraqi patients with T2DM: A comparative study
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The serum protein test includes measurement of the level of total protein(albumin, globulin). Fetuin-A is a blood protein made in liver. It can inhibit insulin receptor, enhance insulin sensitivity and make the individuals more likely to develop type 2 diabetes, then disorder in lipid profile (Total cholesterol(TC), low density lipoprotein cholesterol (LDL-c), high density lipoprotein cholesterol (HDL-c), Triglyceride(TG) and very low density lipoprotein cholesterol (VLDL-c) . To evaluate Fetuin-A, total protein, albumin, globulin, HbAlc and lipid profile in 200 adult and elderly Iraqi patients with type 2 Diabetes Mellitus were taken and compare them with 200 subjects as a healthy control. The laboratory analysis(for patients and

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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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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
Fri Jan 15 2021
Journal Name
Plant Archives
EFFECT OF SEWAGE AND SILICON FERTILIZATION ON THE GROWTH OF PEACH TREES
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Publication Date
Sun Jan 27 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Use of the costs of environmental quality and its impact on income
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        Accompanied Activity Economic Unity some negative effects in the environment of air, water and soil pollution of difficult to measure each other for being the external costs and to be avoided such expenditures should be measured or estimated value to be disclosed environmental costs at the heart of the financial statements of economic unity to inform managers and users of the financial statements on the implications costs environmental .and impact in reducing environmental costs and increase future income and economic unit, was based on research into the inductive approach through books, letters, journals and the internet to cover the theoretical framework of the research. And to the analyt

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Publication Date
Sat Sep 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Disclosure of insurance services and its impact: On the performance of companies
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The objective of the research is to identify the nature of voluntary disclosure of insurance services and its impact on the financial performance of Iraqi insurance companies by knowing the relationship between increasing disclosure of financial services and financial performance indicators of insurance companies.In order to achieve this objective, the research was applied to a sample of the Iraqi insurance companies listed in the Iraqi Stock Exchange (Al Amin Insurance Company, Al Ahlia Insurance, Dar Al Salam Insurance, Gulf Insurance, Al Hamra Insurance) and based on their published financial statements (2014-2015) ) And by analyzing the sample lists were connected to the research objectives.The main conclusion of the study is that in

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