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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
Thu Feb 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Brokerage Firms under Information Asymmetry and its Effect on Common Stock Trade : Applied Research in the Iraq Stock Exchange
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The research aims to Applied Study in the nature of the impact of information asymmetry for brokerage firms in the common stock trading, The research included the theoretical concepts associated with each of the brokerage firms ,information asymmetry and common stock trading, It used the financial methods on the practical side of the information asymmetry for brokerage firms based in the sector as well as trading volume and spread for common stock , The community of the research included the Iraq Stock Exchange,the sample of research the companies listed which have been trading on its stock for the period August 2015 until December 2015 as well as brokerage firms

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
ISO 9001: International Standards and their impact on achieving competitive advantage /An Applied at the private colleges in Iraq
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The results of the analysis showed that there is a correlation between ISO 9001    and the competitive advantage, which shows that the implementation of ISO 9001 in the private colleges achieves a competitive advantage through its ability to employ the entrance of quality systems management according to ISO 9001, By focusing on improving the quality of its educational services in accordance with a clear and understandable policy for all and its ability to meet the expectations, expectations and wishes of students and beneficiaries, which leads to lower costs of operations compared to other colleges and achieve a higher level of reliability and quality and value of services provided and rapid respon

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Mon Oct 01 2018
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Publication Date
Mon Apr 03 2023
Journal Name
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The Effect of Proposed Strategy According to the Realistic Mathematics Theory on the Achievement and Mathematical Interrelation of third Intermediate Students
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The current research aims to identify the effect of the proposed strategy in accordance with realistic mathematics on the achievement and mathematical Interrelation of third Intermediate students. Two samples were tested from the middle third grade in a school affiliated with the General Directorate of Baghdad- Rusafa, the first for the academic year (2022-2021). The experimental group is (30) students taught according to the proposed strategy, and the control group is (30) students based on the traditional method. To achieve the research objective, the researchers developed a test for achievement consisting of (30) items and a test of sports interconnection composed of (20) items. The results of the stu

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Sat May 01 2021
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Mon Jun 01 2015
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Emotions conflict In Balzac’s novel The Father Goriot And Stendhal’s The Red and The Black
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Au XIXe siècle, avec l’excès de la passion, le roman français commence à avoir de nouvelles figures. Il tend à être un reflet de la pensée et de la passion. Stendhal et Balzac révèlent ainsi le conflit de l’âme et donnent à leur héros l’impression que tout est permis.

                Ces protagonistes doivent, d’une part, subir des fluctuations psychologiques, et d’autre part, ces héros doivent être capables de faire face aux rancunes et aux conflits destructeurs. Les personnages stendhaliens et balzaciens finissent par croire que leur combat ne portera pas ses fruits, parce que toute passion déséquilibrée mènera, soit à la fol

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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of Educational And Psychological Researches
Training Program based on Some Strategies of Self-Regulated Learning for the Teachers of Mathematics and its Effect on their Relational Mathematics
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This research aims at building a proposed training program according to the self-regulated strategies for the mathematics teachers and to identify the effect of this program on relational Mathematics of teachers. The sample of the research was (60) Math teachers; (30) teachers as experimental group and (30) teachers as control group. The results of the current research reacheded that the proposed training program according to some self-managed learning strategies, meets the needs of trainees with remarkable effectiveness to improve the level of their teaching performance to achieve the desired goals. Training teacher according to self-managed learning strategies is effective in bringing about the transition of training to their students

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Publication Date
Mon Mar 08 2021
Journal Name
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Effect of Welded Joints Design on the Joint Strength During Statie and Dynamie Loading with Different Current and Type of Wire Welding
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The aim of this research is to study the effect of welded joint design (Butt joint and lap joint) on thejoint strength during tension and fatigue loading with different current of welding (40,50,60,70,80) ^per, and different type of wire welding. The result of this research is showed that the effect of fatigue loading on the type of joint is more than the effect of tension loading on it. And the butt joint welding is better than the lap joint welding during the fatigue loaded.The experimental results of the effect of W'elding current showed that more increasing and more decreasing the value of the heat input, during the welding was found to produce mechanical brittleness on the buttjoint welding during the static and dynamic loading. Also i

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Publication Date
Sat Jan 01 2022
Journal Name
Applied Ecology And Environmental Research
EFFECT OF SPRAYING WITH FOLIC ACID AND YEAST EXTRACT ON THE GROWTH, YIELD AND CALCIUM OXALATE CONCENTRATION OF SPINACH (SPINACIA OLERACEA L.)
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