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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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Wed Dec 12 2018
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Journal Name
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Field experiment was conducted to test the effect of saline water 2 and7 dSm-1 potassium fertilizer rate 150,300 and 450 kg/donum on nitrogen fixation in Pisum sativum L. nodules. The experiment included anatomy study .Results water salinity ( 2,7 dSm-1) as a main plot and fertilizer rates as a sub plot. Results indicated that irrigation with saline water 7 dSm-¹ caused a significant decrease in N contents especially in the lower parts of the plants. The percentage of the N decreased in lower leaves to (0.01%) under 7dSm-¹ and 300 kg/donum fertilizer; however the percentage increased in the upper leaves to (2.80%) under with 2dSm-¹of irrigation water and 300 kg/ donum fertilizer rate. Fresh weight decreased to 6.26g under 7 dSm

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Sat Aug 29 2026
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Modulating Effects of Fimasartan and Omega-3 on Cisplatin-Induced Testicular Toxicity in Rats
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Background: Cisplatin is a widely used antineoplastic drug in different types of cancers (ovarian, testicular, and hematological) with several types of adverse effects, including testicular toxicity. Fimasartan is a newer angiotensin-receptor blocker (ARB) that has antioxidant and anti-inflammatory properties. Omega-3 is an unsaturated fatty acid that has antioxidant and anti-inflammatory effects. Objective: to evaluate the protective effects of fimasartan alone or in combination with omega-3 against cisplatin-induced testicular toxicity. Methods: Thirty Wistar rats were divided into five groups: control group, cisplatin-treated group, fimasartan+cisplatin group, fimasartan+omega-3+cisplatin group, and omega-3+cisplatin group. Trea

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