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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
Tue Nov 11 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Prevalence of Pacifier Sucking Habit and Its Effect on Occlusion in Children Aged 1-5 Years in Baghdad City
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Background: Non-nutritive sucking habits are common in infants and toddlers. One of the most common non-nutritive sucking habits is pacifier; its prevalence varies from one population to another. This study was conducted to determine the prevalence of pacifier sucking habit among children aged 1-5 years old in Baghdad city and to assess its effect on the occlusion of primary dentition concerning posterior crossbite. Materials and methods: The study was carried out among 1222 children aged 1-5 years old, from which 50 children with continues pacifier sucking habit were chosen to be the study group, compared to 50 children without any sucking habit (control group) matching the study group in age and gender. Children were examined clinically t

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Publication Date
Fri Feb 08 2019
Journal Name
Iraqi Journal Of Laser
The Efficacy of (810 Nm) Diode Laser in Treatment of Idiopathic Epistaxis
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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
The Efficacy of fractional CO2 laser in management of surgical wound scars
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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Comparing Several Nonlinear Estimators for Regression Function
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Tue Sep 08 2015
Journal Name
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Publication Date
Mon Jun 27 2022
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Self-Reported Sleep Disorder, Anxiety and Depression in Iraqi Patients Post-Myocardial Infraction
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Background: Myocardial infarction (MI) is distinguished by the necrosis of myocardial cells as a result of substantial and prolonged ischemia. Anxiety, problems sleeping, and feelings of depression are some of the most common psychosocial consequences of having a myocardial infarction. Aim: The purpose of this study is to evaluate the effects of post-myocardial infarction on patients' levels of anxiety, depression, and quality of sleep. Method: The collection of data from 94 individuals with MI was carried out according to a descriptive cross-sectional design. Sleep quality, depression, and anxiety were evaluated using standard questionnaires. Results: 69.1% of the participants reported having trouble getting quality sleep. The perc

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Tue Dec 30 2008
Journal Name
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from 1989 to 1997 amoebic dysentery increase from
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bloody diarrhea in Erbil district.
2. Assess the effect of multiple factors like age, sex,
source of water supply, etc... On the incidence of
amebic and bacillary dysentery.
3. To provide baseline data for making strategic plan to
reduce the diarrhoeal mortality and morbidity.
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Publication Date
Fri Nov 01 2013
Journal Name
The Iraqi Postgraduate Medical Journal
Efficacy and safety of topical podophyllin 5% ointment in patients with mild plaque-type psoriasis
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Publication Date
Wed Oct 31 2018
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Publication Date
Wed Sep 24 2025
Journal Name
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Antibacterial-enhancing efficacy of aloe vera and honey in salicylic acid topical formulations against acne
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