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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
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Study of the Singlet and the Triplet States of Two ElectronSystems in the First Excited State
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A study of the singlet and triplet states of two electron systems in the first excited state was performed using a simple quantum mechanical model, which assigns the 1s,and 2s orbital with two different variational parameters. Our results agree with a high level calculation used by Snow and Bills.

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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
The changes in the thickness of 1000 – 500 MB and it effects the climate of Iraq
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This research paper is about synoptic climate specifically with in the upper air layers
using upper air layers maps analysis which are maps of thickness for the level 1000 – 500
MB, that their high average ranges between 100 – 5600 M above surface. This research paper
focuses on studying special and temporal variations of the atmosphere thickness above Iraqaccording
to this study, it is concluded that atmosphere thickness above Iraq increases
towards south with an average of 100 M as compared with north of Iraq. Regarding the
temporal variations, it is concluded that atmosphere thickness during hot months. In July, for
example, the atmosphere thickness becomes thicker than in January with an average of
(250)M

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Publication Date
Sun Feb 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The role of the integration of the knowledge economy and international accounting in achieving sustainable development
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     The current environment is witnessing several developments as a result of the changes  taking place in all areas of economic, social , political and legal that led to the transformation of the industrial economy , which depends based on quantitative production to a knowledge economy which relies based on information and knowledge , as the central pillar of this economy during the trading  of  these information and knowledge between all individuals in general and decision makers , in particular, through information and communication technology of computers and the Internet to achieve sustainable human development in the social dimension.         &

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Publication Date
Fri Oct 28 2022
Journal Name
Political Sciences Journal
The dialectic of the relationship between democracy and freedom in the political thought of karl popper
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Recent studies agree that the democratic system in a country can only be established in an atmosphere of political and religious freedom. However, the term democracy and the term freedom have become controversial because their concepts remain multiple and different. Karl Popper is one of the most prominent philosophers in modern Western political thought, and one of the defenders of democracy as opposite to dictatorship. It has defined its function by its ability to restrain the ruling elite and to enforce it to prevent their tendency to tyranny. This can be achieved only in the context of the close relationship between democracy and freedom, so, if there is democracy in the absence of absolute freedom, democracy is a gateway to expandin

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Publication Date
Sun Sep 15 2019
Journal Name
Al-academy
The Pleasure of Fear and the Temptation of the Thriller in Horror Cinema: كــاظــم مــؤنـــس عزيز
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In the theory of cinema genre, horror films are at the forefront of the list. It is one of the oldest genres that saw the light with the early emergence of cinema, taking advantage of literary works, especially Gothic literature and it continues to this day, but the third millennium has seen a marked increase in the number of films and recipients alike. There were many types within the same genre and there are many authors and varied topics, all seeking to spread terror and panic and fear in the hearts of viewers who are passionate about the type of horror. Although the fear and horror have been, throughout the ages, a challenge to the psychological balance and stability, as well as being a rejection and an opposition to the aesthetic ta

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Publication Date
Wed Feb 27 2019
Journal Name
Journal Of Low Power Electronics And Applications
Tolerating Permanent Faults in the Input Port of the Network on Chip Router
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Deep submicron technologies continue to develop according to Moore’s law allowing hundreds of processing elements and memory modules to be integrated on a single chip forming multi/many-processor systems-on-chip (MPSoCs). Network on chip (NoC) arose as an interconnection for this large number of processing modules. However, the aggressive scaling of transistors makes NoC more vulnerable to both permanent and transient faults. Permanent faults persistently affect the circuit functionality from the time of their occurrence. The router represents the heart of the NoC. Thus, this research focuses on tolerating permanent faults in the router’s input buffer component, particularly the virtual channel state fields. These fields track packets f

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Publication Date
Fri Sep 08 2023
Journal Name
Hammurabi Journal For Studies
The Impact of the Political Process on Government Stability in Iraq After 2003
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The research in the variables of the political process and government stability tried to show the impact of the political process on political stability first, and then on government stability second, given that the political process that was established in 2005 was aimed at achieving legitimacy, and its most prominent tools are elections, leading to achieving political stability, including government stability. The issue of governmental stability is one of the important issues in Iraq, but it has not been achieved, as a result of several factors, including problems in political action, as the political process has not succeeded in leading Iraq to stability.

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Publication Date
Tue May 01 2018
Journal Name
Journal Of Physics: Conference Series
The Effects of micro Aluminum fillers In Epoxy resin on the thermal conductivity
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Publication Date
Sun Mar 05 2017
Journal Name
Baghdad Science Journal
The Effect of Organic Matter Application on Phosphorus Status in the Calcareous Soil
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A field experiment is conducted to study the effect of different levels of peat (0, 25, 50, 75, and 100 Mg ha-1 to uncropped and cropped soil to wheat. Soil samples are taken in different period of time (0, 3, 30, 60, 90, 120, and 180 days after cultivation to determine (NaHCO3-Exteractable P at 3 different depths (0-10, 10-20, and 20-30 cm). Field Experiment is conducted in a randomized complete block design (RCBD) with four replicates. Wheat, Al-Rasheed variety, is cultivated as a testing crop. The entire field is equally dived in two divisions. One of the two divisions is cultivated to wheat and the second is left uncropped. The effect of five levels of peat namely 0, 25, 50, 75, 100 Mg ha-1 is investigated. Soils are fully analyzed

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Educational And Psychological Researches
The socio-psychological implications on the investigators of police directorate in Hebron district
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The present study aims to identify the socio-psychological implications that police investigators experience regarding the variable of gender, age, place of residence, qualification, military rank, and work experience. The study included 6 individuals who were working in investigation department in Hebron district as a sample. The results demonstrated that the targeted sample had a dump attitude toward the socio-psychological implications. The psychological implications reflected 2.8739, the social side represents 3.2956.

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