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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 Jan 01 2023
Journal Name
Revista Iberoamericana De Psicología Del Ejercicio Y El Deporte
THE PSYCHOLOGICAL EFFECTS OF PERFECTIONISM ON SPORT, ECONOMIC AND ENGINEERING STUDENTS
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Publication Date
Wed Oct 07 2026
Journal Name
Advances In Life Science And Technology
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
Wed Oct 07 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
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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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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Publication Date
Thu Dec 26 2019
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
THE EFFECTS OF TEMPERATURE AND MOISTURE STRESS CONTENT ON THE EXTENSIVE CULTIVATION OF THE OYSTER MUSHROOM
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    Oyster mushroom (Pleurotus ostreatus (Jacq. ex Fr.) P. Kumm.) is involved in the destruction of dead wood which is the main place of settlement of several living organisms. After humification, dead wood also becomes an important component of forest soils.

 

    The purpose of the research is to study temperature and moisture conditions of extensive cultivation of oyster mushrooms on various wood substrates. To accomplish this goal, the following tasks were set: to determine the amount of effective stress temperatures and moisture content of substrates and their influence on the appearance of fruiting bodies of the oyster mushroom; to study the features of the extensive culti

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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
Thu Sep 12 2024
Journal Name
مجلة حمورابي للدراسات
The strategic importance of the Strait of Malacca and its impact on the US-China rivalry
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The Strait of Malacca is one of the waterways of strategic, political, and economic importance. This strait has an increasing importance to its neighboring countries. The Strait of Malacca is very important for China, especially in the field of energy supply security, as the vast ma jority of energy supplies come to China through this strait. China seeks to ensure its security, especially in light of the cooperation of countries that look forward to this strait as well as the United States, and what the United States may cause to China, as many of them are at war with China over the China Sea, not to mention the countries that overlook it. The importance of the research emerges from the basic idea that the strategic importance of the Strait

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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The importance of localizing salaries and its impact on the competitive advantage of the banking sector
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Abstract:

           The aim of the research is to demonstrate the impact of the salary localization service in enhancing banking competitive advantage. In order to achieve this goal, salary localization was chosen as an independent variable and its impact was studied on the dependent variable, which is the competitive advantage. The research problem lies in the fluctuation of the salary localization service from one bank to another and the impact of this on the competitive advantage.  The study sample included five private Iraqi banks, namely (the National Bank of Iraq, the International Development Bank, Assyria International Bank, Al Khaleej Commercial Ban

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