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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 07 2025
Journal Name
Al–bahith Al–a'alami
Cultural and educational values for children
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Programs directed to children through the media in general and in television in particular are among the main factors that help in forming the cultural and educational values of this important segment of society, and in light of this the study problem was identified in answering a major question: What are the cultural and educational values that Ajyal channel seeks Space planted in children through my program, Iftah Ya Simsim (in its new season) and Friends of Ajyal? , While the objectives of the study were evident in identifying the most prominent cultural and educational values that the Ajyal satellite channel worked to instill in children, and identifying the nature of the techniques used by Ajyal channel in providing the value conten

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Publication Date
Sun Oct 06 2013
Journal Name
Journal Of Educational And Psychological Researches
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
Tue Mar 15 2022
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of alveolar bone height in adolescents utilizing Cone Beam Computed Tomography: a retrospective radiographic analysis
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Background: To assess the alveolar bone crest level (ABCL) by Cone Beam Computed To-mography (CBCT) and to investigate several variables as predictors for the height of the alveolar bone in adolescents. Materials and methods: Age, sex, and ethnic groups were rec-orded for each patient. CBCT images were used to obtain measurements of the interproximal alveolar bone level from the cementoenamel junction (CEJ) to the alveolar crest. The highest measurement in each sextant was recorded along with any presence of a vertical bone defect or calculus. Results: Total of 720 measurements were recorded for 120 subjects. No vertical bony defects or calculus were observed radiographically. Statistically significant (P< 0.05) differences were observed be

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Publication Date
Tue Jan 01 2002
Journal Name
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The Effectiveness &amp; Safety of Topical Podophyllin Therapy in Condylomata Acuminata in Iraqi Infants and Young Children.
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KESMM Al, WAA Al-Nuaimy

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Publication Date
Sun Jan 01 2006
Journal Name
Iraqi Journal Of Community Medicine
The Effectiveness &amp; Safety of Topical Podophyllin Therapy in Condylomata Acuminata in Iraqi Infants and Young Children
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KE Sharquie, MM Al-Waiz, AA Al-Nuaimy, IRAQI JOURNAL OF COMMUNITY MEDICINE, 2006

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Publication Date
Fri Aug 29 2014
Journal Name
American Journal Of Pharmacological Sciences
Efficacy and Safety of Ranibizumab Intravitreal Injections versus Laser Photocoagulation in Patients with Diabetic Macular Edema
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Publication Date
Thu Sep 03 2020
Journal Name
Political Sciences Journal
The Requirement of the National Democratic project in Iraq post Daesh Terrorist Group Stage
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This study aims at re-transmit the spirit of the national democratic project of Iraq post of the chaos left by the Daesh terrorist group stage(The Islamic State of Iraq and Syria, ISIS) , Which controlled large parts of Iraq, and had an adverse effect on the political scene in Iraq, inspired everyone that there are deficiencies in the political, economic, religious and ethnic structure of the Iraqi people in non-response to democratic thought.The researcher relied on the hypothesis that " the requirements of building a democratic project are based on the need to provide the requirements ranging from two interrelated aspects, like the institutional aspect and the aspect that related to the general and necessary requirements for the establ

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Publication Date
Fri Jan 15 2010
Journal Name
Joijrnal Of College Ofeducation
Association between Insulin Resistance and Mellitus type 1 in children
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Aim of the study is to find any correlation between obesity (insulin resistance) and type I diabetes in children. Obesity and diabetes mellitus are the common health problems, and obesity is common cause of the insulin resistance. The results revealed marked increased in glucose, insulin, HbAlc and insulin resistance in obese diabetic type I patients comparing to control group they were obese and non-obese found to be within normal values for glucose, insulin, FIbAlc , and insulin resistance.

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Sat Dec 30 2023
Journal Name
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Health System in Iraq Post 2003 War
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Background: War represents a major human crisis; it destroys communities and results in ingrained consequences for public health and well-being

Objective: We set this study to shed light on the public health status in Iraq after the successive wars, sanctions, sectarian conflicts, and terrorism, in light of certain health indicators.

Design: The primary source of data for this analysis comes from the Iraqi Ministry of Health, and The World Health Organization disease surveillance.

Results: Most of the morbidity indicators are high, even those that are relatively declining recently, are still higher than those repor

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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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