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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
Wed Jun 26 2024
Journal Name
Iraqi Journal Of Agricultural Sciences
EFFECTS OF LIVE BODY WEIGHT AND LEPTIN CONCENTRATION ON IRAQI CHICKENS FERTILITY AND HATCHABILITY
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This Study was conducted out at the Ministry of Agriculture's Poultry Research Station/Animal Resources Department/Agricultural Research Center. To see how body weight (BW) and leptin hormone (LEP) levels in breeder blood affect fertility and hatchability. 140 Iraqi local laying chickens (120 females + 20 males) aged 28 weeks were used in the study. Following the numbering of females, the birds were grown in individual cages and dispersed sequentially on cages. The experiment was divided into three periods, each lasting 28 days, during which the breeder's live body weight was recorded and divided into two categories (greater than 1.5 kg and less than 1.5 kg), and blood samples were collected at the end of each period to determine th

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Thu Dec 26 2019
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Journal Of Accounting And Financial Studies ( Jafs )
Integration of internal audit and external audit and its impact on combating money laundering
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Financial institutions, including banks, remain a major target for money launderers in order to transfer illegal funds to legitimate funds through limited internal audit procedures and external auditing.

The study is a study of the operations of money laundering and what can be done by the verification efforts when integrated in the fight against them, by analyzing the level of cooperative relationship and communication between them. To achieve the objectives of the study, a questionnaire prepared for this purpose was distributed to an appropriate sample of (60) auditors of the internal audit staff of the Central Bank of Iraq and the external auditors working in the Federal control foundation Accordingly , appropriate methods wer

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Fri Feb 09 2001
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Molecular Crystals And Liquid Crysta
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Twelve compounds containing a sulphur- or oxygen-based heterocyclic core, 1,3- oxazole or 1,3-thiazole ring with hydroxy, methoxy and methyl terminal substituent, were synthesized and characterized. The molecular structures of these compounds were performed by elemental analysis and different spectroscopic tequniques. The liquid crystalline behaviors were studied by using hot-stage optical polarizing microscopy and differential scanning calorimetry. All compounds of 1,4- disubstituted benzene core with oxazole ring display liquid crystalline smectic A (SmA) mesophase. The compounds of 1,3- and 1,4-disubstituted benzene core with thiazole ring exhibit exclusively enantiotropic nematic liquid crystal phases.

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Mon Nov 23 2020
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Indian Journal Of Forensic Medicine & Toxicology,
The Clinical Effect of Super Oxidized Water Mouthwash on The Periodontal Parameters (Plaque Index, Gingival Index And Bleeding on Probing) for Patients with Dental Biofilm Induced Gingivitis
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Wed Sep 30 2015
Journal Name
College Of Islamic Sciences
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Conflict resolution and conflict resolution

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Which affected the growth of some markets
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The search for the return of economic and cultural activity and the emigration of some others
Cultural exchange and trade, which in turn
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Economic and heritage
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As well as tourism and tourism, as it depends on the abundance of visitors, tourists and residents in terms of needs and motivation
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Tue Oct 11 2022
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And the purposes of faith are the wisdom and secrets contained in the Islamic faith and which achieve human well-being and happiness in the immediate and the future. And that the purposes of belief and faith are the essence of religion, rather it constitutes a basic pillar on which the basis of the intentional consideration as a whole, because the structure of worship i

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Publication Date
Mon Feb 02 2026
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The Influence of Using Special Exercises with Weights to Develop Moments of Force to Some of the Striking Shoulder and Arm Muscles and Accuracy of the Skill of the Smash and Rectum in Volleyball
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This research is an attempt to develop exercise with weights to strengthen some of the striking muscles in the shoulder and arm and to develop the accuracy of the smash and rectum skills. The importance of this paper lies in the study of moments of force to achieve the ability to control muscular work and to explore the impact of physical and skill exercises with weights to develop moments of force for some muscles. The experimental method on a sample of players, selected according to the intentional method, including ( 9) advanced players representing Air Force Club participating in the Premier League for season 2011-2012. It is concluded that the exercises proposed have their effective impact on developing the variables of moments force f

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Mon Apr 11 2022
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International Journal on Technical and Physical Problems of Engineering
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Sat Jan 01 2022
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Preparation and characterization of silver self-metallization on polyimide
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