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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 Jan 01 2020
Journal Name
Journal Of Xi'an University Of Architecture & Technology
The Effect of (Landa) Model on Acquiring Grammatical Concepts Upon His Request to the College of Administration and Economics University of Bagdad
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The current research aims to identify the impact of the (Landa) model on acquiring grammatical concepts among students of the College of Administration and Economics, University of Baghdad, and to achieve the research goal, the researcher has set the following hypotheses: There are no statistically significant differences at the level of significance (0.05) between the average degrees Students of the experimental group who studied the Arabic language according to the (Landa) model and the marks of the students of the control group who studied the same subject in the usual way in the post test, there are no statistically significant differences at the level of significance (0.05) in the average differences between the test scores before and

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Publication Date
Wed Apr 01 2020
Journal Name
Indian Journal Of Forensic Medicine And Toxicology
Study the genotoxicity of aqueous and alcoholic extracts of adhatoda vasica on the roots of allium cepa L. By RAPD-PCR technique
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Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Strategic orientation and its reflection on the Learning organization: Survey study of a sample of Makers decision the Iraqi Ministry of Communications
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Publication Date
Fri Mar 01 2024
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Experimental and analytical study of the energy and exergy performance for different evaporative pads in hot and dry climate
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Wed Feb 01 2017
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Wed Jan 02 2019
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An Instructional Design According to the Active Learning Model and Its Effect on Students' Achievement in Chemistry for Fifth Intermediate Stage
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Publication Date
Mon Dec 31 2012
Journal Name
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Experimental Study on the Impact of External Geometrical Shape on Free and Forced Convection Time Dependent Average Heat Transfer Coefficient during Cooling Process
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In this research, an experimental study was conducted to high light the impact of the exterior shape of a cylindrical body on the forced and free convection heat transfer coefficients when the body is hold in the entrance of an air duct. The impact of changing the body location within the air duct and the air speed are also demonstrated. The cylinders were manufactured with circular, triangular and square sections of copper for its high thermal conductivity with appropriate dimensions, while maintaining the surface area of all shapes to be the same. Each cylinder was heated to a certain temperature and put inside the duct at certain locations. The temperature of the cylinder was then monitored. The heat transfer coefficient were then cal

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Sun Jan 17 2021
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Publication Date
Sat Feb 09 2019
Journal Name
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The Effect of Combining Video Lectures and Kolb Experiential Learning on EFL Student-Teachers’ Ability to Teach Communicative Coursebook and their Teaching Competencies
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