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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
Mon Jul 01 2013
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
ON THE OCCURRENCE OF THE[ MONOGENEAN GYRODACTYLUS TAIMENI ERGENS, 1971 FOR THE FIRST TIME IN IRAQ ON GILLS OF THE COMMON CARP CYPRINUS CARPIO
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The monogenean Gyrodactylus taimeni Ergens, 1971 was recorded in this study for the first time in Iraq from gills of the common carp Cyprinus carpio Linnaeus, 1758. The description and measurements of this parasite as well as illustration were given. In addition, a list of species of Gyrodactylus so far recorded from C. carpio in Iraq is also included together with a list of all other hosts recorded for each gyrodactylid species.

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Publication Date
Thu Sep 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Continuous Improvement Strategy (Kaizen) in organizational innovation: An analytical research in the General Company of Electrical and Electronic Industries /The Ministry of Industry and Minerals
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This paper aims at the fact that most organizations today suffer from a waste of time, effort, and cost, and they have difficulty in achieving the best performance situations and compete strongly. The researcher distributed 108 questionnaires as a statistical analyzable sample society where the sample intentionally consists of general managers, department head, and division head. The questionnaire was formulated according to the Likert scale. The use of personal interviews and observations are additional tools for data collection and a number of statistical methods is used for data analysis such as simple regression and correlation coefficient (Pearson). One of the most prominent conclusions is that the company has adequate and c

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of fraud detection skills in the settlement of Compensatory claims for the fire and accident insurance portfolio: An applied study in the national and Iraqi insurance companies
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The research seeks to identify the impact of fraud detection skills in the settlement of compensatory claims for the fire and accident insurance portfolio and the reflection of these skills in preventing and reducing the payment of undue compensation to some who seek profit and enrichment at the expense of the insurance contract. And compensatory claims in the portfolio of fire and accident insurance in the two research companies, which show the effect and positive return of the detection skills and settlement of the compensation on the amount of actual compensation against the claims inflated by some of the insured, The research sample consisted of (70) respondents from a community size (85) individuals between the director and assistan

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Publication Date
Mon Feb 02 2026
Journal Name
Political Issues
(The Libyan crisis in the Turkish and Iranian perspectives)
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The Turkish intervention in the Libyan crisis in the recent period was a trigger for more tension than a solution - as Turkey claims - as Turkey seeks to quickly set a welcome military footing in Libya to prevent the reconciliation government from falling and planning to start exploration for gas and oil in Libya to solve the Turkish energy crisis, that is, the energy exchange for security and trying to exploit the situation to establish a new gathering of proTurkish political Islam, as for the Iranian position on the Libyan crisis, it does not exceed a logistical role and provide Turkey with expertise in circumventing international sanctions and assisting it in transporting fighters and weapons to Libya, Iran has also deliberately added so

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Publication Date
Mon Jun 10 2024
Journal Name
Humanities And Social Sciences Communications
The mediating role of accounting information systems in small and medium enterprise strategies and organizational performance in Iraq
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Abstract<p>This paper examined accounting information systems (AIS) as a mediator between small and medium-sized enterprises (SMEs) strategies, including (finance source, administrative innovation, organizational culture, developing capabilities levels of SMEs, information source, development of business managers, and technological innovation) and organizational performance. In this quantitative study, 450 self-administered questionnaires were distributed to the managers and owners of SMEs using purposive sampling. Data were analyzed using the structural equation modeling (SEM) method via SmartPLS3 Software. The study offers empirical findings on the importance of AIS as a mediator, considers various factors, a</p> ... Show More
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Publication Date
Tue May 16 2023
Journal Name
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The Effect of Spatial Organization on the Sustainability of the Neighborhood Unit in the Residential Environment
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Contemporary residential neighborhoods suffer from weak sustainability of urban residential environments as a result of the adoption of inefficient spatial organization at the neighborhood unit level. This resulted negative characteristics which affected the achievement of sustainable development plans for the residential environment that constitute the majority of the urban fabric of cities.

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Publication Date
Fri Mar 01 2024
Journal Name
Baghdad Science Journal
The Association between Single Nucleotide Polymorphisms rs1042522 and rs1642785 in the TP53 gene and Acute Myeloid leukemia in a sample of the Baghdad/ Iraq population
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Acute myeloid leukemia (AML) represents the most prevalent type of acute leukemia in adults and is responsible for approximately 80% of all cases. The tumor suppressor gene (TP53) is a gene that has been frequently studied in cancer, and mutations in this gene account for about 50% of human cancers. This study aims to evaluate the correlation between two single nucleotide polymorphisms (SNPs) in the gene: rs1042522 and rs1642785, and a group of Iraqi patients suffering from pre-diagnostic acute myeloid leukemia (AML). Blood samples were collected from sixty patients (26 males and 34 females) and sixty controls (26 males and 34 females); these subjects were matched in gender, age, and ethnicity. Genomic DNA has been extracted fro

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Publication Date
Thu Nov 09 2023
Journal Name
Journal Of Global Scientific Research In Business Management And Economics
The profitability index and its role in evaluating the performance of specialized banks in Iraq.
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Central banks around the world typically use various financial indicators to evaluate performance. In Iraq, the indicators used by central banks to evaluate the performance of banks are of great importance to ensure that the banks operating within the Iraqi banking system comply with the regulatory and legal requirements issued by the Central Bank of Iraq or the Ministry of Finance. Given the need to study the profitability indicator to ensure its ability to evaluate the performance of specialized banks in Iraq, these banks carry out their banking activities and businesses through capital funded by the government. The use of profitability indicators in evaluating the performance of specialized banks provides information about the profitabil

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Publication Date
Wed Jan 09 2019
Journal Name
Преподаватель ХХi век | مجلة الاستاذ في القرن الواحد و العشرين
Arabic borrowings in the Russian language and features of their actualization in the modern period
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Publication Date
Thu Jun 24 2021
Journal Name
Ibero-american Journal Of Exercise And Sports Psychology
The effect of an educational curriculum based on metacognitive skills in teaching some offensive skills on the specialized school of basketball in Baghdad governorate
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The educational process depends on the means of conveying information from the teacher to the learner. Whenever appropriate, this means the learning process takes place better, faster, and with less effort, and the problem of research lies. The players lack learning in the meta-knowledge curriculum in basketball offensive skills than offensive skills. The aim of the research is to identify the effect of training exercises for educational numbers based on metacognitive skills in teaching some offensive skills with basketball. As for the research assignment, there are statistically significant differences between the results of the pre and post tests for the experimental group and in favor of the post tests. The experimental approach was used

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