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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 Jan 01 2018
Journal Name
Opción
Abnormal emotional behavior in children and its rela- tionship to televised violence
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Publication Date
Tue Mar 01 2005
Journal Name
Saudi Medical Journal
Condylomata acuminata in infants and young children. Topical podophyllin an effective therapy.
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KE Sharquie, MM Al-Waiz, AA Al-Nuaimy, Saudi medical journal, 2005 - Cited by 8

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Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
T-Cells Proliferation and Serum Cytokine levels in Type 1 Diabetic Children
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Background: There is plenty of evidence
suggesting that involvement of several groups of
viruses in the development and / or acceleration of
Type 1 Diabetes Mellitus (T1DM).
Objective: To analyze the T- cell proliferation in
the presence of Coxsackie virus B5 (CVB5), Polio
and Adenovirus antigens in addition to assessment
of Interferon- gamma (IFN-γ), Interleukins (IL-10
and IL-6).
Methods: In 60 Iraqi T1DM children with recent
onset of T1DM, Lymphocyte proliferation was
analyzed using Methylthiazol tetrazolium (MTT)
assay by culturing Peripheral Blood Lymphocytes
(PBLs) with Coxsackie Virus B5 (CVB5),
Adenovirus, and Polio vaccine. Serum Interferon-γ,
IL-10 and IL-6 were quantified by sandw

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Publication Date
Sun Oct 01 2023
Journal Name
Baghdad Science Journal
Ghrelin and Obestatin Levels as a Novel Marker in Iraqi Obese Children
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Obesity is an escalating health problem in developing countries. One to ten children worldwide are overweight in a report showed by the International Obesity Task Force. Ghrelin, orexigenic peptide, has 28 amino acids, it is considered the greatest remarkable promotion in the last two decades for understanding the physiological changes of action regu­lating food intake and hunger. Obestatin is a 23-amino acid peptide nearly connected to ghrelin that secures from substitutio

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Publication Date
Wed Jan 01 2020
Journal Name
International Journal Of Engineering Business Management
Using ANN in emergency reconstruction projects post disaster
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The purpose of this study is to avoid delays and cost changes that occur in emergency reconstruction projects especially in post disaster circumstances. This study is aimed to identify the factors that affect the real construction period and the real cost of a project against the estimated period of construction and the estimated cost of the project. The case study is related to the construction projects in Iraq. Thirty projects in different areas of construction in Iraq were selected as a sample for this study. Project participants from the projects authorities provided data about the projects through a data collection distributed survey made by the authors. Mathematical data analysis was used to construct a model to predict change

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
Parental Treatment Styles and their Relationship to Self-Efficacy among Middle School Students
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The current research aims to identify the level of parental treatment methods tolerance, hostility, strictness, and warmth, as well as the level of self-efficacy among middle school students. Moreover, it aims to identify the correlation relationship between the variables of parental treatment methods and self-efficacy among middle school students. The research sample included (150) middle school students. For achieving the objectives of the current research, the researchers adopted a scale of parental treatment methods prepared by (Zughair, 2006), and a scale of self-efficacy prepared by (Youssef, 2016), which were applied in their final form to the research sample. The research reached the following results: parents use a low-level hos

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Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The Logical Maturity of Kindergarten Children
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The aim of this research is to measure the logical maturity of kindergarten children. To achieve this aim, the researcher adopted the scale of Gold Schmid and Bentler (1968), which was translated to the Arabic language by Shabili (1988). The scale was administered to a sample of (100) kindergarten children were chosen randomly from a number of kindergartens in Baghdad city for the academic year (2017-2018). SPSS was used to analyze the collected data. The results revealed there is a level of logical maturity among the kindergarten children. The researcher came out with a number of recommendations and suggestions.                     &

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Publication Date
Thu Jun 13 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Association of the MDR1 Variants (rs2032582 and rs2032583) with Steroid Response in Iraqi Children with Idiopathic Nephrotic Syndrome
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Background: Several studies linked the development of steroid-resistant nephrotic syndrome (SRNS) to genetic variations in the multidrug resistance 1 (MDR1) gene, though a disparity in findings was underlined among children with different ethnic origins. Objective: This study examined the relationship between MDR1 variants (rs2032582 and rs2032583) and the risk of developing SRNS in Iraqi patients with idiopathic nephrotic syndrome (INS). Methods: This case-control study included children with steroid-sensitive INS (SSNS; n=30) and SRNS (n=30) from the Babylon Hospital for Maternity and Pediatrics. Sanger sequencing was used to determine the participants’ genotypes. Results: The rs2032582 genotypes and alleles were not associated

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Publication Date
Fri May 30 2025
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Exploring Dental Students' Perspectives: The Impact of Hybrid Learning in a Post-Pandemic World
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Background: The pandemic crisis prompted the world to adopt unexpected approaches to continue life as normally as possible. The education sector, including professors, students, and the overall teaching system, has been particularly affected. Objective: This study seeks to evaluate the benefits, challenges, and strategies related to COVID-19 from the perspectives of college students, particularly those in higher education in Iraq. Method: The online survey questionnaire was distributed via Google Forms and specifically aimed at undergraduate dental students. Results: A total of 348 students participated in the survey. There was a significant correlation (P > 0.01) between student satisfaction with hybrid learning and their experi

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Publication Date
Mon Mar 01 2021
Journal Name
Journal Of Physics: Conference Series
Serum iron status in association with pregnancy outcomes in infertile women undergoing IVF/ICSI
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Abstract<p>Iron status can affect the outcome of <italic>in</italic> vitro-fertilization (IVF) in infertile women who undergoes this process. The aim of this study is to evaluate iron status, ceruloplasmin ferroxidase activity and their association with outcome of pregnancy prior to initiation of IVF/ICSI procedure. The participants were fertile women with male cause infertility (control; n=25), women with polycystic ovary syndrome (PCOS; n=21), women with low anti-Müllerian hormone level (AMH; n=26), and women with unexplained infertility (UI; n=27). Blood samples were obtained on the day of oocyte aspiration. Serum iron, ferritin, transferrin level, and ceruloplasmin ferroxidase act</p> ... Show More
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