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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 Mar 14 2013
Journal Name
Journal Of Kerbala University 11 (3)‏
Effect of chemical fertilization and gibberellic acid on the contentofsomechemical compounds of Nepali and Khudairi cultivars of olive‏
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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Analyzing the impact of exchange rate fluctuations and inflation on the GDP in Iraq using the modern methodology of Cointegration for the period (1988-2020)
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     The research aims to analyze the impact of exchange rate fluctuations (EXM and EXN) and inflation (INF) on the gross domestic product (GDP) in Iraq for the period 1988-2020. The research is important by analyzing the magnitude of the macroeconomic and especially GDP effects of these variables, as well as the economic effects of exchange rates on economic activity. The results of the standard analysis using the ARDL model showed a long-term equilibrium relationship, according to the Bound Test methodology, from explanatory (independent) variables to the internal (dependent) variable, while the value of the error correction vector factor was negative and moral at a level less than (1%). The relationship bet

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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
Problematic intervention in the new international order and its impact on international relations - the U.S. role a model
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Intervention in International Relations from the concepts that are still highly
controversial among those he considers a breach of international law and the UN Charter and
in violation of the rule , and those who felt that the need provided, however, that this is linked
motives humanity recognized by the international community , because the international
variables proved the inadequacy of the principle of non-interference and the principle of
sovereignty as the traditional variables international , and therefore most of the international
practice came a bus with many of the behaviors that reflect a decline in its entirety to these
principles , and became adapt these principles with international reality is too compl

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Publication Date
Wed Mar 15 2023
Journal Name
Journal Of Tikrit University For Humanities
The Egyptian-Chinese Consensus at the Bandung Conference and Its Impact on Strengthening Relations between Them in 1955
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كان المؤتمر الآسيوي الأفريقي الأول الذي عُقد في مدينة باندونغ الاندونيسية عام 1955 هو المؤتمر هو الأول الذي اجتمعت فيه الدول الآسيوية والأفريقية بعد الحرب العالمية الثانية. كان مؤتمر باندونغ بمثابة نقطة الانطلاق نحو تأسيس حركة عدم الانحياز، والتي كانت مصر أحد أبرز أقطابها. شهد المؤتمر تقاربا في الآراء ووجهات النظر بين جمهورية مصر العربية وجمهورية الصين الشعبية، لا سيّما وإن الحكومة المصرية كانت قد تبنت س

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
The Effect of Heat Treatment on the Magnetic and Mechanical properties offe - Ni alloys.
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The aim of this work is studying the binary system ??'??? Ni?)with two ratios (y=36,80) by using casting method for preparing the samples.Magnetic and Mechanical properties have been studidt different httrea^nttem^rature.All the alloys were found a ferromagnetic behavior and sensitive to the heat treatment. Best properties were found at the heat treatment 1100 C°.A significant different results were found above 1100C° for lower magnetic and mechanical values. This is possibly due to the change on the degree of magnetic moment orders, in which most of the moments are started to remove from coupled ferromagnetically.?

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Publication Date
Sun Jan 05 2014
Journal Name
Journal Of Educational And Psychological Researches
The educational violence and it's reflections on study attainment of the primary stage pupils
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Chapter-1

Problem of the research: 

The studies and researches have noticed the aggravation of violence practice in all educational means using different and innovated styles against children in the school and house in order to upbringing by the parents or the school .

It is a training method for the person to participate in the society and prepare him to be an effective member.

The current research confines the children in age (6-12) years old representing the primary stage who face different kind of violence during the familiar or school education.

The current research aims to:

1 – The kinds of violence which happens to the children in the primary

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Publication Date
Mon Feb 20 2023
Journal Name
Baghdad Science Journal
Modeling and Analyzing the Influence of Fear on the Harvested Modified Leslie-Gower Model
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A modified Leslie-Gower predator-prey model with a Beddington-DeAngelis functional response is proposed and studied. The purpose is to examine the effects of fear and quadratic fixed effort harvesting on the system's dynamic behavior. The model's qualitative properties, such as local equilibria stability, permanence, and global stability, are examined. The analysis of local bifurcation has been studied. It is discovered that the system experiences a saddle-node bifurcation at the survival equilibrium point whereas a transcritical bifurcation occurs at the boundary equilibrium point. Additionally established are the prerequisites for Hopf bifurcation existence. Finally, using MATLAB, a numerical investigation is conducted to verify t

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Publication Date
Sun Oct 01 2023
Journal Name
Baghdad Science Journal
Modeling and Analyzing the Influence of Fear on the Harvested Modified Leslie-Gower Model
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A modified Leslie-Gower predator-prey model with a Beddington-DeAngelis functional response is proposed and studied. The purpose is to examine the effects of fear and quadratic fixed effort harvesting on the system's dynamic behavior. The model's qualitative properties, such as local equilibria stability, permanence, and global stability, are examined. The analysis of local bifurcation has been studied. It is discovered that the system experiences a saddle-node bifurcation at the survival equilibrium point whereas a transcritical bifurcation occurs at the boundary equilibrium point. Additionally established are the prerequisites for Hopf bifurcation existence. Finally, using MATLAB, a numerical investigation is conducted to verify the va

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Scopus (11)
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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
the effect of temperatures and humidity rates on the mean weight loss from developement
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The effect of some environmental factors in the loss rate for high weights virgins are full to the screwworm fly of the ancient world and included temperatures 15,20,25,30,35,40 study showed that the rate of loss in weight virgins advanced to full participants at a temperature of 15 C while notgets evolution

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Publication Date
Mon Jun 28 2021
Journal Name
Journal Of Engineering
The Catholyte Effects on The Microbial Desalination Cell Performance of Desalination and Power Generation
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A microbial desalination cell (MDC) is a new approach to bioelectrochemical systems. It provides a more sustainable way to electrical power production, saltwater desalination, and wastewater treatment at the same time. This study examined three operation modes of the MDC: chemical cathode, air cathode, and biocathode MDC, to give clear sight of this system's performance. The experimental work results for these three modes were recorded as power densities generation, saltwater desalination rates, and COD removal percentages. For the chemical cathode MDC, the power density was 96.8 mW/m2, the desalination rate was 84.08 ppm/hr, and the COD removal percentage was 95.94%. The air cathode MDC results were different

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