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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
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
The Role of Education in Enhancing the Value of Citizenship in Children through the Interactive Life Process in Educational Institutions
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The aim of the research is to diagnose the methods of enhancing the value of citizenship in children through the interactive life process in educational institutions; the descriptive approach was used to achieve the objective by identifying social theories that corresponded to the national value or the theoretical principles of citizenship education. The study focused on educational activities and their role in establishing values, national educational philosophy in interactive activities, as well as the presentation of previous studies on the subject of citizenship, and maps of each of the strategies of active learning, skills in the process of interactive life in the field of education, Institutions that have the responsibility to prom

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Tue Aug 09 2022
Journal Name
Journal Of Research In Medical And Dental Science
Evaluation of the Antibacterial Efficacy of Electrolyzed Oxidizing Water as an Irrigant against Enterococcus faecalis (An In vitro Study)
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Publication Date
Wed Jan 01 2025
Journal Name
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Efficacy of hypochlorous acid solution in comparison with povidone iodine solution for the management of infected diabetic foot ulcers
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Tue Jan 01 2019
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Indian Journal Of Public Health Research & Development
Impact of Breast Feeding Duration on the Presence of <i>Candida</i> in Relation to Nonnutritive Sucking Habit among Group of Iraqi Children
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Mon Apr 20 2026
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TRANSLATION STRATEGIES OF PHRASEOLOGICAL UNITS FROM ITALIAN INTO RUSSIAN: BASED ON V. ARDONE’S NOVEL THE TRAIN OF CHILDREN
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The translation of phraseological units is among the most challenging tasks in literary translation, as fixed expressions convey denotative, connotative, and cultural meanings that resist full equivalence. This study classifies the strategies employed in the Russian translation of Viola Ardone’s The Train of Children, drawing on the frameworks of Vinay and Darbelnet, Newmark, and Koller. Analysis of 37 idioms reveals five strategies, with phraseological equivalence prevailing, while compensation—though less frequent—emerges as stylistically most significant.

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Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Financial technology as one of the recovery strategies of the Iraqi banking sector in the post-Covid-19 stage: An exploratory study
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Publication Date
Thu Jan 13 2022
Journal Name
Journal Of Research In Medical And Dental Science
Impact of Bad Oral Habits on Dental Caries among 6-10 Years Old Children in Hilla City
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Background: There is a clear debate about the role of bad oral habits (thumb-sucking and biting nails) and on oral health and the state of the dental caries, but there is no doubt that continuing these bad habits until advanced ages will lead to deep and difficult problems to solve. Objective: The purpose of study was to evaluate the effect of bad habits, include finger sucking and nail biting on dental caries among children aged from 6 to 10 years old. Subjects and methods: In Al-Hilla city, Iraq, a comparative study was conducted in which (200) primary school students aged between 6 to10 years old were involved. A questionnaire filled out by their parents was used to gather information related to the bad oral habit, and then all the stude

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Background: Thalassemia is characterized by the decrease or absence of the synthesis of one or more globin chains of hemoglobin. Thalassemia is distributed worldwide and is characterized by; regular blood transfusion which is creating alloimmunization to erythrocyte antigens is one of the major complications of regular blood transfusions in thalassemia, particularly in patients who are chronically transfused.Objectives: The aims of this study are to understand the immune system profile as the triggering factor for thalassemia.Methods: Thirty patients aging between one year and four months and twenty two years, twenty two of them were boys and eight were girls. Twenty nine patients, their parents are relative except one and studied in the

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Publication Date
Sun Mar 01 2020
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The Efficacy of Poppy, Papaver nudicaule extract as an Anesthetic for the Common Carp, Cyprinus carpio
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Aqueous extract of poppy plant) Papaver nudicaule) with five concentrations (50, 100, 150, 200 and 250) mg/l were used to anesthetize fingerlings of the common carp Cyprinus carpio (Mean total length 8.91 ± 0.31 cm and mean total weight 7.72 ± 1.19 gm) instead of the traditional use of MS-222. Results showed that extracted solution of poppy have partial and overall anesthesia effect on these fishes with inverse relationship between the concentrations used and the time needed to reach partial and overall anesthesia, and also direct relationship between concentrations used and time needed for fish recovery. Best results were obtained by using a concentration of 250 mg/l, where time for partial anesthesia was 8 ± 1.52 m

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