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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 23 2025
Journal Name
Journal Of Al-turath University College
The role of the Prophet ( peace be upon him and progeny) in the field of the Administration Regulation and applying Shura Principle Council in Islamic State Administration
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Publication Date
Fri Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The impact of strategic approach in the effectiveness of small and medium Enterprises in Iraq
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The purpose of this research highlight the achievement of the effectiveness of small and medium enterprises dimensions and conformable to analyze the relationship between business strategies and human resources management strategies , and launched search of a dilemma thought provoking fundamental questions revolve around the search is the lack of appropriate strategies in these enterprises to help them continuity and permanence in business and markets , as these enterprises lack the human resources management strategies appropriate , as well as business strategies that make them withstand the changes in the market environment is changing and volatile . It was to

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Publication Date
Tue Feb 04 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
A Comparative Study on the Probability of Diabetes and Psychosocial Deficiency of Badminton Players Youth Category
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Many people believe that diabetes appears after a psychological crisis, which is a misconception but it could be in them before having a crisis ore the crisis. But emotion increases the appearance of symptoms, and athletes are at risk of developing diabetes. Hypoglycemia is not unusual for athletes, and during physical activity the sugar level changes in the blood. Therefore, it is important to conduct tests for the measurement of sugar before and immediately after the activity, for the purpose of detecting the sharp drop in the sugar level and treating it, and the early detection is necessary to avoid the possibility of diabetes, the concept of psychological immunity in psychology is considered a positive concepts that maintain the balance

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Publication Date
Thu Apr 29 2021
Journal Name
International Journal Of Pavement Engineering
An assessment of lime-cement stabilisation on the elastic and resilient moduli of a clayey soil
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Publication Date
Thu Dec 01 2022
Journal Name
Journal Of Engineering
Influence of Waste Concrete and Glass Recycled on the Strength Properties of Green Reactive Powder Concrete
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These days, the world is facing a global environmental and sustainability problem due to the increasing generation of large amounts of waste through construction and demolition work, which causes a serious problem for the environment. Therefore, this research was conducted to get rid of the waste disposal problems, including old glass and concrete, which were used as recycled fine aggregates. Seven different mixtures were prepared. The first mixture was with the used sand, which is glass sand, and it was adopted as a reference mixture (ORPC), and three mixtures were prepared for each of the recycled materials (waste concrete and glass) and partially replaced by glass sand in different proportions (25, 50, and 75) %. Some

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Performance Auditing Of Hotels Sector Under (Covid-19) And It’s Reflection On The Outcome Of Activity
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Publication Date
Sun Aug 21 2022
Journal Name
International Journal Of Health Sciences
Effect of x- ray on the treatment of breast cancer combined with amygdalin and doxorubicin separately
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Background: Radiation therapy has the ability to destroy healthy cells in addition to cancer cells in the area being treated. However, when radiation combines with doxorubicin, it becomes more effective on breast cancer treatment. Objective: This study aims to clarify the effect of X-ray from LINAC combined with amygdalin and doxorubicin on breast cancer treatment, and the possibility of using amygdalin with X-ray instead of doxorubicin for the breast cancer treatment. Method: Two cell lines were used in this study, the first one was MCF-7 cell line and second one was WRL- 68 normal cell line. These cells were preserved in liquid nitrogen, prepared, developed and tested in the (place). The effect of three x-ray doses combined with a

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The competitive environment influences the increase in exercise intensity and hence adds to the growth of training and practice. The study objective.to identify the effect of competitive speed exercises on the effectiveness of skill performance and speed of counterattack for junior boxers, as well as to know the rate of development for these variables.Materials and methods. The research sample consisted of twelve up-and-coming Al-Najda Sports Club players who participated in the national tournament and were selected with care. They were placed into two groups, control and experimental, with six boxers each in the control and experimental groups. The two groups were assigned identical weights on purpose, and their ages range from 15 to 16 ye

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Publication Date
Wed Dec 01 2021
Journal Name
Iraqi Journal Of Physics
Impact of Aluminum Oxide Content on the Structural and Optical Properties of ZnO: AlO Thin Films
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AlO-doped ZnO nanocrystalline thin films from with nano crystallite size in the range (19-15 nm) were fabricated by pulsed laser deposition technique. The reduction of crystallite size by increasing of doping ratio shift the bandgap to IR region the optical band gap decreases in a consistent manner, from 3.21to 2.1 eV by increasing AlO doping ratio from 0 to 7wt% but then returns to grow up to 3.21 eV by a further increase the doping ratio. The bandgap increment obtained for 9% AlO dopant concentration can be clarified in terms of the Burstein–Moss effect whereas the aluminum donor atom increased the carrier's concentration which in turn shifts the Fermi level and widened the bandgap (blue-shift). The engineering of the bandgap by low

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Publication Date
Wed Apr 10 2019
Journal Name
مجلة كلية التربية الاساسية
The effect of Mentha viridis and Apium graveolens leaves on growth of Beta vulgaris var. cilica
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The experimental was carried out to study the effect of Mentha viridis and Apium graveolensleaves by 5, 10 gm/kg soil that added then to soil alone and 5, 10 gm/kg soil together on growth of Beta vulgaris plants. The results showed that increased significantly germination accelerator, plant height leaves number fresh and dry maters, chlorophyll content, absolute growth rate, inflorescence number, fertilizer efficiency while the N, P, K and Fe increased in all the treatment plants compared with control plants.