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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 Aug 26 2026
Journal Name
Al–bahith Al–a'alami
The role of witchery and astrology programs in spreading illusion and myth
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« The emergence of satellite channels has led to fundamental changes in the supposed role of television, making it a center of culture and an important tributary to social upbringing and influencing the attitudes and values of individuals and in making public opinion regarding various issues, some television programs target ordinary people at home by virtue of the nature of their subjects, where there is a large audience of viewers, who consume and absorb what is offered to them from the cultural production of those satellite channels that play with the aspirations of groups of society to find metaphysical or magic solutions to their social problems or psychological delusions. The media, through its various messages, contributes to brin

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Publication Date
Sun Aug 04 2024
Journal Name
International Journal Of Home Science
The phenomenon of drugs in Iraq and its international and national impacts
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Abstract Drug addiction is considered a criminal behavior, which led the Iraqi legislator to prohibit and criminalize it, imposing penalties on those who use or even approach it. This aims to limit its presence in Iraq and reduce unethical behaviors, leveraging the divine prohibition to curb it. The legislator also encourages media organizations to raise awareness about the dangers of this substance, which has contributed to reducing the phenomenon of drugs in Iraq.

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Publication Date
Sun Oct 07 2012
Journal Name
Journal Of Educational And Psychological Researches
The Participation of the Students of the Colleges of Education in the Iraqi Universities in Literacy and Adult Education in Iraq. The Students of the Departments of Holy Quran and Islamic Education (A model)
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The study focuses on the problem that Iraq is approaching an increasing rate of literacy;the available data refers to a rate of (18% -19%). In addition to the fact that the generalcurrent role of the programs directed to literacy is not actually effective enough to limit the expansion of this rate.

The importance of this study highlights the fact that the Iraqi universities are an important tributary among the tributaries of human development, especially in spreading the education of the voluntary work in literacy field and confirming the connection between the students and their society and their role in solving one of the prominent challenges that face the development, i.e., literacy.

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Publication Date
Wed Jan 31 2024
Journal Name
Journal Of The Faculty Of Medicine Baghdad (jfacmed Baghdad)
The Role of Activin A levels, Body Mass Index and Beta-Human Chorionic Gonadotropin in Ectopic Pregnancies and Missed Abortions – A Study on a Group of Iraqi Women
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Publication Date
Fri Jun 02 2023
Journal Name
East European Journal Of Physics
Electroexcitation Form Factors and Deformation of 20,22Ne Isotopes Based on the Shell Model and Hartree-Fock plus BCS Calculations
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Nuclear structure of 20,22Ne isotopes has been studied via the shell model with Skyrme-Hartree-Fock calculations. In particular, the transitions to the low-lying positive and negative parity excited states have been investigated within three shell model spaces; sd for positive parity states, spsdpf large-basis (no-core), and zbme model spaces for negative parity states. Excitation energies, reduced transition probabilities, and elastic and inelastic form factors were estimated and compared to the available experimental data. Skyrme interaction was used to generate a one-body potential in the Hartree-Fock calculations for each selected excited states, which is then used to calculate the single-particle matrix elements. Skyrme interac

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Publication Date
Tue Mar 31 2026
Journal Name
Frontiers In Mechanical Engineering
Finite-element guided drilled-hole placement and fillet geometry effects on the structural and dynamic performance of spur gears
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In this research, a detailed finite-element (FE) analysis of the combined influence of the drilled-hole position, the shape of the hole, and the fillet design on the structural and dynamic performance of spur gears is investigated. ANSYS R16.2 was used to create a three-dimensional numerical model that can be used to assess the bending stress distribution and vibration response under realistic loading conditions. A trochoidal fillet and four circular fillet radii (0.5, 1.0, 1.5 and 2.0 mm) were studied to determine their effect on the stress concentration behavior. FE-guided hole-suggestion process was introduced which is an automated process in which low-stress zones to be cut away are identified so as to allo

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Mon Jan 07 2013
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Journal Of Educational And Psychological Researches
The effective of utilization Blending learning on academic achievement in Biology course of second class students in secondary special schools in Omdurman Locality and attitudes towards it.
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Wed Mar 15 2023
Journal Name
Al-academy
Scenography and the effectiveness of meaning in the theatrical space
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Fri Jan 05 2024
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Wed Mar 15 2023
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Visual Appeal and Reflection in the Design of the Advertising
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