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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
Sun Dec 31 2017
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study the Effect of Using Microwave Radiation and H-Donors on Improving Heavy Oil
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The present research has investigated the effect of microwave energy on improving the flow properties of heavy crude oil. The fragmentation of crude oil molecules was carried out with and without using 1 and 10 wt. % concentration of various types of H-donors like tetralin, cyclohexane, and naphtha.  Microwave power of 320, 385, and 540 W and radiation time 1-9 min, and temperature were studied. The kinematic viscosity and asphaltene content were measured for evaluation the improving of heavy crude oil.

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Publication Date
Sun Apr 01 2007
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Observations on the ultrastructure of a rat mammary gland treated with harmal and borage
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Sat Jul 17 2021
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Based on the theoretical review of researches and studies concerned with virtual teams in organizations, it was found that the role of virtual teams varies from case to another, and it may be positive or opposite. The purpose of the current research is to examine the role of virtual teams in the impact of cultural intelligence on the strategic excellence of Zain worldwide Group. An electronic questionnaire was designed through the (Google) and (Microsoft) forms, and distributed then on a sample of (146) participants with a high organizational level of the HRM departments within the group. The results showed that there was a positive moderator role of virtual teams in the relationship of cultural intelligence and strategic excellence

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Publication Date
Sun Mar 06 2011
Journal Name
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Publication Date
Fri May 25 2018
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Sat Dec 01 2018
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Publication Date
Sat Dec 01 2018
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The Future of the Russian- Ukrainian War and the Extent of its Reflection on the Security of Eastern European Countries after 2022
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Wars represent one of the most serious threats to the world order; It is considered a violation of international laws and norms, and humanitarian principles. From this point comes the study of the importance of the topic entitled (The Future of the Russian-Ukrainian war and the extent of its Reflection on the security of Eastern European countries after the year 2022). This study is based on reviewing future possibilities (scenarios) of war. The Russian-Ukrainian war, which was launched by the Russian government led by Russian President Vladimir Putin in February 2022, is still ongoing at the time of writing this research. This chapter includes three possibilities (scenarios). The first possibility deals with the development of the war t

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