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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
Sat Aug 22 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of different finishing and polishing systems on surface roughness of new low polymerized composite materials (An in vitro study)
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Background: Prophylaxis methods are used to mechanically remove plaque and stain from tooth surfaces; such methods give rise to loss of superficial structure and roughen the surface of composites as a result of their abrasive action. This study was done to assess the effect of three polishing systems on surface texture of new anterior composites after storage in artificial saliva. Materials and methods: A total of 40 Giomer and Tetric®N-Ceram composite discs of 12 mm internal diameter and 3mm height were prepared using a specially designed cylindrical mold and were stored in artificial saliva for one month and then samples were divided into four groups according to surface treatment: Group A (control group):10 specimens received no surfa

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Influence of Teacher and Students Errors Correction Techniques on Students’ Achievement in English at College of Physical Education for Women
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The research is an attempt to investigate experimentally the influence of teacher’s errors correction and students’ errors correction on teaching English at the College of Physical Education for Women. Errors are seen as a natural way for developing any language but teachers are puzzled the way they can correct these errors. So, this research gives some idea of using two types of errors correction. The sample of the research is female students of the first year stage at the College of Physical Education for Women of the academic year 2009-2010. The whole population of the research is (94) students while the sample is (64). Thus, the sample represents 68% from the population of the research. The sample represents It is hypothesized th

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Study the Effect of Folic Acid as A supplement on Selected Oxidative Stress and Biochemical Parameters in First Trimester of Pregnancy
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Folic acid modulates several disorders in humans, pregnancy mostly because of the mitochondria-rich placenta, is a condition that favors oxidative stress.Transitional metals, especially iron, which are particularly abundant in the placenta, are important in the production of free radicals. Adenosine deaminase (ADA), an enzyme essential for the differentiation of lymphoid cells, has been used for monitoring diseases with altered immunity. In the present study we investigated the effect of regular and irregular administered folic acid in the first and second trimester of pregnancy to be compared with non-pregnant women ,and also the effect of regular and irregular using of folic acid  supplement on  oxidative stress parameters an

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Publication Date
Fri Dec 30 2022
Journal Name
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The Exploratory and Confirmatory Factorial Structure of Test-Wiseness Scale: A Field Study on a Sample of Students in Hama University
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The influence of pulse duration and exposure time of Er,Cr:YSGG laser on lithium disilicate laminate debonding, an in vitro study
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Investigating the Effect of Drugs of Chloramphenicol and Gentamicin on Acanthamoeba genotype T3 Causing keratitis Isolated from Environmental samples in vitro
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This study is an investigation of the drugs effect on some pathogenic Acanthamoeba isolated from Iraqi waters, where the problem of environmental adaptation that characterizes this organism in addition to being a reservoir for many pathogenic microorganisms that take shelter in it to escape disinfectants and medicines is sometimes difficult to treat it with traditional treatments.  Twenty water samples were collected from different water regions in Iraq, namely the Dokan Lake, Tigris River, Euphrates River and Najaf Sea, 5 samples from each source.  Acanthamoeba was isolated from water samples on NNA and PYG media, using an inverted microscope with an electron microscope to determine their phenotypic features. PCR and

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Wed Dec 01 2021
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Publication Date
Wed Dec 25 2019
Journal Name
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Non-interest income and its impact on the profits of the Iraqi banking sector: (Comparative study)
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Mon Jan 01 2024
Journal Name
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The impact of digital transformation on the relationship between commercial bank customers’ empowerment and competitive advantage
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