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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
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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Artemisia is a perennial wild shrub with large branches and compound leaves. Artemisia contains about 400 types, and its medical importance is due to the presence of many active substances and compounds such as volatile oils, alkaloids and flavonoids, glycosides, saponins, tannins, and coumarins. This study was designed to study the effect of the aqueous extract of the fruit of the Artemisia plant on the organs of the body, as well as to know its ability to activate the hepatic enzyme alanine transaminase (ALT/GPT). The fruit of this shrub was extracted using the measurement technique gas chromatography-mass spectrometry (GC/MASS) and organic solvent hexane and ethyl acetate in one to one ratio. It contained 21 compounds, a high percentage

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Plastic, Reconstructive & Aesthetic Surgery
The effect of facial expression on facial symmetry in surgically managed unilateral cleft lip and palate patients (UCLP)
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Publication Date
Wed Jun 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Modes of Knowledge acquisition and their reflections on the tacit knowledge A field study in Tuz General Hospital
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This research aims to knowledge the extent of the application of Tuz General Hospital to the concept of tacit knowledge dimensions (mental models, intuition, experience, skill) and methods of acquiring knowledge dimensions (training, job rotation, work teams) and the measurement and analysis of the link and the kind of impact between the methods of acquiring knowledge and tacit knowledge of the Angels nursing in the researched hospital, and was the questionnaire primary means of collecting information adopted by the researcher that, the research sample of (90) individuals, including the Angels nursing, has been using the statistical program spss for the purpose of conducting statistical treatments, and through the diagnosis and m

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Publication Date
Mon Aug 26 2024
Journal Name
Jbpml
Studying The Changes in Motility and Morphology on Human sperm after exposure to low doses of x-rays
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the energy that a radiation source emits as light (photons), electromagnetic waves, or particles is known as radiation. X-ray is one type of ionizing radiation that falls within the electromagnetic wave category of short wavelengths. Because of their short wavelength. X-ray is a type of ionizing radiation that is used in a constantly growing number of diagnostic procedures. X-ray diagnostic imaging has been employed in the medical field for more than a century(Hariyoto et al., 2020). Radiation has advantages for human health, but there is also a risk. the impacts of Radiation on Fertility it is an oligospermia, or a reduction in the number of sperm cells, which is already possible after radiation exposure of 0.15 mGy. It Leads to impede

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Publication Date
Tue Dec 01 2020
Journal Name
The Saudi Dental Journal
The impact of salivary lactoperoxidase and histatin-5 on early childhood caries severity in relation to nutritional status
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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Indian Academy Of Oral Medicine And Radiology
The Degenerative Condylar Change in Temporomandibular Joint Disorder of Iraqi Population and their Variability Based on Clinical Diagnosis
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Background: As a multifactorial disorder, temporomandibular joint (TMD) is difficult to diagnose, and multiple factors affect the joint and cause the temporomandibular disorder. Standardization of clinical diagnosis of TMD should be used to reach a definite clinical diagnosis; the condylar bone may degenerate in accordance with these disorders. Aims: Evaluate the correlation between the clinical diagnosis and degenerative condylar change (flattening, sclerosis, erosion, and osteophyte). Materials and Methods: A prospective study with a study group of 97 TMD patients (total of 194 joints) aged 20 to 50. Patients were sent to cone beam computed tomography (CBCT) to assess the degenerative condylar change. Results: No association was found bet

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Publication Date
Sat Jun 19 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Pharmacological Effects of Kappa Carrageenan on Different Human Cell Lines and Genomic DNA: An in vitro study
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Carrageenan extract is a compound of sulfated polyglycan that is taken out from red seaweeds. Being hydrocolloid in nature, carrageenan has gelling, emulsifying and thickening properties allowing it to be commonly used in the oral healthcare products and cosmetics. Due to its bioactive compounds, carrageenan has been shown to have antimicrobial, antiviral, and antitumor properties. The purpose of this work is to study the probable use of carrageenan on the diseases that are related to oral cavity and on the genomic DNA in in vitro experimental model

In this study, the effects of k-carrageenan on four different cell lines related to the cancer and normal cells which cultured on selective media were done. Moreover, the eff

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Publication Date
Sun Jul 31 2022
Journal Name
Pakistan Journal Of Medical & Health Sciences
Application of program for nurse’s management about care of children treated with Ventricular Peritoneal Shunt
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Publication Date
Wed Mar 23 2022
Journal Name
World Economics & Finance Bulletin (wefb)
ANALYSIS OF THE CAUSALITY RELATIONSHIP BETWEEN SPENDING ON HIGHER EDUCATION AND SOME ECONOMIC VARIABLES IN IRAQ FOR THE PERIOD 1990-2020
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Higher education is important because it creates and develops human capital and provides qualified human cadres, which requires restructuring government spending so that an increase in funding allocated to education is brought about. During the period 1990-2020, government spending was weak on educational institutions in Iraq, which led to a decline in The role of these institutions in the economic development of the country. The highest percentage of spending on higher education of GDP was 0.47% in 2007 and the lowest was 0.01% in 2005. The number of public universities reached 35, and the number of private universities and colleges reached 64 universities and private colleges in 2020. This was accompanied by an increase in the number of s

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Publication Date
Sun Jan 18 2026
Journal Name
Iraqi Journal Of Mechanical And Material Engineering
THE INFLUENCE OF FRICTION FACTOR ON THE COMBINED CONVECTIVE AND RADIATIVE HEAT TRANSFER IN A RECTANGULAR DUCT WITH INTERIOR CIRCULAR CORE
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