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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 Jun 28 2018
Journal Name
Journal Of The College Of Education For Women
The function and Formation of NORTH ATLANTIC TREATY ORGANZIAITON as (NATO) Post Cold War Period
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The problem of this study lies in that NATO was formed in the first place to protect Europe from Warsaw Pact. The geographical and military strategy have been changed with the change of its mission and expanding its operation scope with the leadership of the USA in the international scens. The latter has made this organization as the military arm to tighten its control over strategic regions.

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Publication Date
Wed Aug 31 2022
Journal Name
Al-kindy College Medical Journal
Health-Related Quality of Life in Diabetic Women with Comparing Obese & Normal weight
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Background: The prevalence of both obesity & diabetes are increasing all over the world & more in women.  They have a negative impact not only on morbidity & mortality but also on quality of life.

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Sun Aug 07 2022
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The Combined Strengthening Effect of CFRP Wrapping and NSM CFRP Laminates on the Flexural Behavior of Post-Tensioning Concrete Girders Subjected to Partially Strand Damage
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The studies on unbonded post-tensioned concrete members strengthened with Carbon Fiber Reinforced Polymers (CFRPs) are limited and the effect of strengthening on the strain of unbonded pre-stressed steel is not well characterized. Estimating the flexural capacity of unbound post-tensioned members using the design methodology specified in the design guidelines for FRP strengthening techniques of bonded post-tensioned members does not provide a reliable evaluation. This study investigates the behavior of unbonded post-tensioned concrete members with partial strand damage (14.3% and 28.6% damage) and strengthened with CFRP laminates using a near-surface mounted technique with and without U-wrap anchorages. The experimental results show

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Fri Feb 04 2022
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Detecting Damaged Buildings on Post-Hurricane Satellite Imagery based on Transfer Learning
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In this article, Convolution Neural Network (CNN) is used to detect damage and no damage images form satellite imagery using different classifiers. These classifiers are well-known models that are used with CNN to detect and classify images using a specific dataset. The dataset used belongs to the Huston hurricane that caused several damages in the nearby areas. In addition, a transfer learning property is used to store the knowledge (weights) and reuse it in the next task. Moreover, each applied classifier is used to detect the images from the dataset after it is split into training, testing and validation. Keras library is used to apply the CNN algorithm with each selected classifier to detect the images. Furthermore, the performa

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Surgical outcomes of 14 consecutive bilateral cleft lip patients treated with a modified version of the Millard and Manchester methods
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Cultural and educational values for children
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Sun Oct 06 2013
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Awareness of children 's rights from the perspective of parents and educators kindergarten in the city of Baghdad
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The subject of children's rights in the modern era of the priorities of educators , because the child in the community is the future , which is held by the hope which is the basis for society in the renaissance and progress so quickly communities to prove these rights through its various institutions and issued legislation and held numerous conferences and taking specialists the field of childhood Aatron aspects of this rights and Aasalunha including a benefit for children until tomorrow for the rights of children , psychological and social health and educational . Therefore, the current study focused on the awareness of parents and educators of children's rights as individuals most closely satisfying their needs and rights. The

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Publication Date
Thu Dec 25 2025
Journal Name
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Enamel defect of primary and permanent teeth in relation to nutrients daily intake among Down's syndrome children in comparison to normal children
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Background: Any child with Down's syndrome does not develop in the same manner as normal child. Therefore, the child should not be viewed as being like everyone else. Developmental enamel defects in primary teeth have been found at least twice as frequently in disabled children as in control children. Down's syndrome consumed protein more than the recommended daily allowance compared to other disabled groups. Therefore, the aim of this study was to investigate developmental defects of enamel and their relations to nutrient intake among Down's syndrome children in comparison to normal children. Materials and Methods: A sample consisted of fifty institutionalized Down's syndrome children (study group) and 50 normal children (control group)

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Self-Efficacy and its Relation to the Cognitive Assessment for the Daily Disturbances for the University of Baghdad Students
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The current research tackles the self-efficacy and its relation to the cognitive assessment for the daily disturbances for the University of Baghdad students. Two criteria have been adopted to achieve the objectives of the research. The sample of this study consists of 200 male and female students who were chosen randomly. The data were analyzed statistically, revealing that the university students owned their own self-efficacy as well as a cognitive assessment for the daily disturbances and they recognized them as self-threatening. The results also indicated the existence of a prediction activity in the field of the cognitive assessment to the daily disturbances selection. In light of the acquired results, the study recommends the neces

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