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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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Extraction and identification of parsley (Petroselinum sativum) seeds flavonoids (apigenin), as well as evaluation its anticancer efficacy was the main aim of the current study. Thin layer chromatography results clarified that apigenin is the major flavonoid in parsley seeds. The cytotoxic effect of apigenin in mammary adenocarcinoma (AMN3) bearing mice was manifested through significant (P ≤ 0.01) reduction in tumor volume and growth rate inhibition (90.8 %) after 24 days of oral administration at a dose of 300 mg/kg body weight. The volume of tumor in the treated group reached 1354.8 mm³ while the recorded size of the control was 14758 mm³. Transplanted cancer mice showed a significant (P ≤ 0.01) elevation in concentration of liver,

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Sat Jan 12 2019
Journal Name
Journal Of The College Of Education For Women
Self- Awareness of Emotions and its Relation to the Way of Helping of Kindergardens' Children
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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Awareness of the problem technological poisoning Media of parents of kindergarten children and their teachers
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The childhood stage is considered the most important stage of all the stages through
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Publication Date
Wed Dec 30 2020
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Publication Date
Mon Apr 04 2022
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Fear of Intimacy and its Relationship with Post-Traumatic Stress Disorder among Yazidis Women
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Publication Date
Sun Jun 01 2014
Journal Name
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Comparing Bayesian methods to estimate the failure probability for electronic systems in case the life time data are not available
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Publication Date
Wed Dec 30 2020
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Iraqi women Attitude towards Immediate Post-partum/ Post-abortion Contraception: a multi-institutional study
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Background: Immediate postpartum contraceptive and post abortion contraception methods are effective safe methods and are becoming a standard practice in many countries, yet it is not widely used in Iraq.

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Publication Date
Sun Jun 03 2007
Journal Name
Al-kindy College Medical Journal
Parental perception of fever in children
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Publication Date
Sat Jun 30 2007
Journal Name
Al-kindy College Medical Journal
Parental Perception of Fever in Children
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Back ground : Fever is a common medical problem in
children. parents have been shown unrealistic fears of
harmful effects of fever in their children. Resulting in
inappropriate management of fever in their children.
Objective: the objective of this study was to survey
parents about their knowledge andattitude concerning fever
in their children.
Methods : The study involved random selection of
parents who brought their febrile children to emergency
department or out-patient clinics of five teaching and non
teaching hospitals in Baghdad from first of October to end
of December 2002.
Parents of 400 febrile children were interviewed using a
standard questionnaire to obtain sociodemographic
informatio

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Publication Date
Fri Dec 14 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effect of Electronic Games on Children Behaviors who Attending Teaching Hospitals in Baghdad City
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children's behaviors that attending to teaching hospitals in Baghdad city during the period of (October/ 20th
/2017 to March/1st /2018). A (50) purposive (non- probabilistic) sample from: Child Protection teaching
Hospital, Child Central Hospital in AL-Iskan. The sample is selected according to the criteria: Children who
visited the consulting unit of children in the hospitals in the first visit, children in

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