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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
Mon Mar 13 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of Tea Tree, Thymus Vulgaris and Nigella Sativa Oils on The Elimination of Enterococcus Faecalis (In Vitro Study)
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ABSTRACT Background: The main goal of chemomechanical endodontic treatment is the reduction or elimination of microorganisms from root canal system. The intracanal medicaments were used to enhance the disinfection process. This study was conducted to evaluate the antibacterial effect of thymus vulgaris, tea tree essential oils and cold pressed black seed oil (BSO) against E.faecalis. Materials and methods: E.faecalis was isolated from ten patients in need for endodontic treatment. The sensitivity of E.faecalis to the tested oils was evaluated in different concentrations in agar well diffusion method and compared with calcium hydroxide. The sensitivity of E.faecalis to vapor of the tested oils was also evaluated, in disk vaporization method

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Publication Date
Sat Jan 10 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The Influence of Caries Infiltrant Combined with and without Conventional Adhesives on Sealing of Sound Enamel (In Vitro Study)
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Background: The formation of white spot lesions around fixed orthodontic attachments is a common complication during and after fixed orthodontic treatment, which hinders the result of a successfully completed orthodontic treatment. The aim of the study was to assess the effectiveness of the Caries Infiltrant (ICON®) on prevention of caries on the smooth enamel surface when applied alone or combined with conventional adhesives. Materials and methods: Seventy eight human premolar enamel discs were randomly assigned to six groups (n=13). The discs were etched and treated with resins of different monomer content forming the following groups: (1)Untreated etched samples served as the negative control, (2) ICON® (DMG), (3) Adper™ S

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Publication Date
Wed May 01 2019
Journal Name
The Journal Of Immunology
Protective effect of resveratrol on the integrity of alveolar and intestinal epithelial barrier in SEB-induced acute lung injury
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Publication Date
Sun May 02 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Enhancing Auditor Reporting In Light Of International Assurance Standards And Their Reflection On Activating The Credibility Of Sustainability Reports
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Publication Date
Wed Oct 20 2021
Journal Name
Journal Of Engineering Research
Effect of several patterns of floating stone columns on the bearing capacity and porewater pressure in saturated soft soil
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One of the common geotechnical problems is the construction on soft soil and the improvement of its geotechnical properties to meet the design requirements. A stone column is one of the well-known techniques used to improve the geotechnical properties of soft soils. Sometimes thick layers of soft soil imposed the designer to use floating stone columns for improvement of such soil; in this case, the designer will be lost the end bearing of the stone column. In this study, the effects of several patterns of floating stone columns distribution under footing on the bearing capacity of soil and the distribution of excess porewater pressure are investigated. The soft soil used in this study has a very low undrained shear strength (cu) of

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Wed Nov 13 2024
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Publication Date
Tue May 16 2023
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Singapore has invested its human resources for the development of the country since earlier times, so it has directed attention to the education sector. Education and development complement each other, as investment in education has contributed over several years to the development of Singapore economy and has made it one of the strongest economies in Asia and the world. Despite the obstacles that faced educational policies in Singapore, the presence of a wise leadership capable of overcoming difficulties and solving them, and providing the appropriate atmosphere for the development of education has contributed significantly to making it one of the most advanced educational systems in the world, and making this system the main pillar for

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Publication Date
Mon Aug 25 2025
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Iraq Acadmic Journals
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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Efficiency of public investment spending and its impact on economic growth in Iraq For the period 2003- 2013
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Publication Date
Wed Feb 01 2023
Journal Name
Archives Of Razi Institute
The Effect of Active Compounds and Trace Elements Extracted from Artemisia Fruit on Some Liver Enzymes in Humans
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