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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 Sep 20 2021
Journal Name
Key Engineering Materials
Heat Treatment at Different Temperatures and its Effect on the Optical Properties of Pure PMMA and PMMA-Coumarin
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The effect of thermal treatment on optical constants of pure PMMA and with addition (15 and 35) ml of coumarin at different temperatures (100, 110 and 120) C0 for 1 hour were investigated. Cast method used to prepares films of pure PMMA and PMMA with (15 and 35) of coumarin. UV/VIS spectrometer technique used to measure the absorption spectra for these films. The optical constant (absorption spectra and absorption coefficient) don’t changes after applied temperatures in pure PMMA film but the optical constant (absorption spectra and absorption coefficient) in PMMA with (15 and 35) ml of coumarin increased with applied temperatures. The optical energy gap of pure PMMA and PMMA with (15 and 35) ml of coumarin sl

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Comparative Effects of Fentanyl, Medazolam, Lignocaine and Propranolol on Controlling the Hemodynamic Pressor Response during Laryngoscopy and Intubation
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Laryngoscopy and tracheal intubation are considered the most invasive stimuli in anesthesia. They provoked cardiovascular responses that include hypertension, tachycardia and dysrhythmias. Various pharmacological approaches have been used to blunt or attenuate such pressor responses. The present study was designed to evaluate the effect of medazolom, lignocaine and propranolol as a valuable adjuvant to fentanyl in attenuating hemodynamic responses to endotracheal intubation in normotensive patients. Thirty two patient with physical status I or II according to the score of American Society of Anesthesiologist (ASA), scheduled for elective surgery under standard general anesthesia, were randomly allocated into four groups (8 patients in ea

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Publication Date
Thu May 24 2018
Journal Name
Aip Conference Proceedings
The study effect of weight fraction on thermal and electrical conductivity for unsaturated polyester composite alone and hybrid
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In this research prepared two composite materials , the first prepared from unsaturated polyester resin (UP) , which is a matrix , and aluminum oxide (Al2O3) , and the second prepared from unsaturated polyester resin and aluminum oxide and copper oxide (CuO) , the two composites materials (Alone and Hybrid) of percentage weight (5,10,15)% . All samples were prepared by hand layup process, and study the electrical and thermal conductivity. The results showed decrease electrical conductivity from (10 - 2.39) ×10-15 for (Up+ Al2O3) and from (10 - 2.06)×10-15 for (Up+ Al2O3+ CuO) .But increase thermal conductivity from( 0.17 - 0.505) for (Up+ Al2O3) and from (0.17 - 0.489) for (Up+ Al2O3+ CuO).

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The Effect of Dry Farming and Water Stress under Subsurface Drip Irrigation System on Water and Rice Productivity
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Tue Apr 18 2023
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Public relations programs and its role to enhance the morale of employees in the Ministry of Transportation: A survey study on the State land Transport Company
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Wed Jan 23 2019
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Risk of non-compliance and its impact on the profitability of Islamic banks: (Applied res earch in the Islamic Cooperation Bank)For the years (2016-2012)
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College Of Islamic Sciences
Views of Amadi and Gorgani In the metaphor in their books budget and mediation
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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
The phenomenon of building the act of the actor and the effect in the Quranic readings                          (Structural and semantic study)
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After this systematic presentation of the phenomenon of rotation of formulas, ie the construction of the verb and the verb, and the narrated narratives therein differed among the readers, it became clear to us how the difference was clear between reading and the other, and how readers have varied in their readings of the verb, As we have noted through our modest research that the phenomenon of building the verb for the actor and the effect have included the act of both past and present tense, and not limited to a specific time, and this difference in reading was not limited to a particular environment, but beyond To more than one environment This is evidenced by the readings of various readers from the environment of Kufa, Basra, Mecca,

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Publication Date
Thu Oct 09 2025
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Spectrophotometric Determination of Sulfanilamide in Pure and in Synthetic Sample based on Condensation Reaction Method
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A new, Simple, sensitive and accurate spectrophotometric methods have been developed for the determination of sulfanilamide (SNA) drug in pure and in synthetic sample. This method based on the reaction of sulfanilamide (SNA) with 1,2-napthoquinone-4-sulphonic acid (NQS) to form N-alkylamono naphthoquinone by replacement of the sulphonate  group of the naphthoquinone sulphonic acid by an amino group. The colored chromogen shows absorption maximum at 455 nm. The optimum conditions of condensation reaction forms were investigated by: (1) univariable method, by optimizing the effect of experimental variables; (different bases, reagent concentration, borax concentration and reaction time),     (2) central  composite design (CCD) including

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