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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 Dec 02 2020
Journal Name
International Journal Of Pharmaceutical Research
Therapeutic efficacy of protein compound extraction fromMetapenaeusaffinisagainst glucosamine sulphate-induced nephrotoxicity in male rats
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Publication Date
Fri Dec 14 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Teaching Program on Nurses' Knowledge Concerning the Side Effects of Chemotherapy among Children with Leukemia at Oncology Wards in Baghdad City
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Objective(s): to assess the effectiveness of educational program on nurses' knowledge concerning the side
effects of chemotherapy among children with leukemia.
Methodology: A descriptive analytic (quasi – experimental) design study was carried out at Baghdad City from
2
nd of October to 27th of June 2015. Non-probability sample of (35) male and female nurses was selected from
the Oncology Wards in Children Welfare, Child's Central and Baghdad Teaching Hospital. The study
instruments consisted of two major parts to meet the purposes of study. The first part is related to nurses'
demographic characteristics and the second part (four domains) is related to nurses' knowledge concerning the
side effects of chemothera

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Publication Date
Fri Nov 01 2013
Journal Name
Iraqi Postgraduate Medical Journal
Post Hair Epilation Acneiform Eruption Among Females
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KE Sharquie, HR Al-Hamami, IK Sharquie, AA Noaimi, HM Al-Karawy, Iraqi Postgraduate Medical Journal, 2013

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Publication Date
Thu Feb 12 2026
Journal Name
Basic Education College Magazine For Educational And Humanities Sciences
Developing the design structure of Iraqi children magazine covers
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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Movement Skills in Diabetic children Kindergarten Department
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The current research aims at studying the precise and big movement skills and the ability
of the diabetic child to do them, The research sample consisted of ten diabetic children who
go to the Diabetes Center of Research that is apart of the Yarmook hospital. The sample was
chosen according to the intentional method and it wasn’t possible to have bigger sample
because the parents of the children didn’t agree for fear on the children’s health. It was
apparent through the research that the diabetic child performs the big movement skills better
than his ability to do the precise movement skills because they require accuracy,
concentration and high attention.
The most prominent recommendations and suggestions.

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Publication Date
Sat Jun 01 2024
Journal Name
Materials And Structures
Exploring the efficacy of sawdust ash as a mineral filler substitute for the production of asphalt mixtures
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Many waste materials can be repurposed effectively within asphalt concrete to enhance the performance and sustainability of pavement. One of these waste materials is sawdust ash (SDA). This study explores the beneficial use of SDA as a substitute for limestone dust (LD) mineral filler in asphalt concrete. The replacement rate was 0%, 15%, 30%, 45%, and 60% by weight of total mineral filler. Scanning electron microscopy (SEM) was employed to assess the surface morphology of Sawdust (SD), SDA, and LD. In addition, a series of tests, including Marshall stability and flow, indirect tensile strength,moisture susceptibility, and repeated uniaxial loading tests, were conducted to examine the performance characteristics of asphalt mixtures of diffe

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Publication Date
Wed Dec 15 2021
Journal Name
Annals Of R.s.c.b.
IMPACT OF A SOCIAL SUPPORT FOR PREGNANT WOMEN UPON THEIR PREGNANCY OUTCOMES AT MATERNITY HOSPITALS IN BAGHDAD CITY
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Objective: To assess the impact of a social support for pregnant women upon their pregnancy outcome Methodology: A descriptive purposive study was used to assess the impact of a social support on their pregnancy outcomes. The study was conducted from (22 \ September \ 2020 to 15 \ February \ 2021). A non-probability sample (purposive sample) was selected from 100 women. Data were collected through an interview with the mother in the counseling clinic, during the third trimester of pregnancy, as well as after childbirth in the labor wards to assess the outcome of pregnancy. Data were analyzed through descriptive statistics (frequency and percentages). Results: The most important thing observed in this study was the positive pregnancy outcome

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Publication Date
Wed Mar 02 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Training Program to Improve some Aspects of Sensory Integration Disorder and Its Effect on Self-Direction Among a Sample of Children with Intellectual Disabilities
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The present research was conducted to investigate the effectiveness of a training program to improve some aspects of sensory integration disorder and its effect on self-direction among a sample of children with intellectual disabilities. The study sample consists of (10 subjects as an experimental group) were exposed to the training program، and the control group consists of (10 subjects as a control group) were not exposed to the training program. The study included the following tools: A scale of self-direction for intellectual disability (prepared by the researcher). Training program (prepared by the researcher). The Results of the study showed the following: There are no statistically significant differences between the means ranks

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Publication Date
Mon Nov 27 2023
Journal Name
Journal Of Periodontal Research
Ability of gingival crevicular fluid volume, E‐cadherin, and total antioxidant capacity levels for predicting outcomes of nonsurgical periodontal therapy for periodontitis patients
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Abstract<sec><title>Objectives

To determine the potential of gingival crevicular fluid (GCF) volume, E‐cadherin and total antioxidant capacity (TAC) levels to predict the outcomes of nonsurgical periodontal therapy (NSPT) for periodontitis patients.

Background

NSPT is the gold‐standard treatment for periodontal pockets < 6 mm in depth, however, successful outcomes are not always guaranteed due to several factors. Periodontitis‐associated tissue destruction is evidenced by the increased level of soluble E‐cadherin and reduced antioxidants in oral fluids which could be used as predictors for success/failure of N

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Publication Date
Wed May 18 2016
Journal Name
Al-academy
The Role of T.V. Shaws in Transmitting Violence in Children: An Analytic Study for T.V. Chanels for Children During 1/3/2014 – 1/9/2014: يوسف محمد حسين
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Our study comes up to clarify the role of television in spreading the culture of violence with a child. This study represents one of the important studies that have tried to highlight the impact of these programmes, particularly cartoons, on the child's behaviors, actions and acquired habits.Violence considers a common phenomenon among the people, as the role of the media, particularly TV has a vital role due to its properties, characteristics and its significant impact on different segments and groups in society and in children particularly through exposure to programmes of films.The results of the study have been affected by the rising proportion of females to males, and that the contribution of real life has a big role in the child ac

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