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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 Mar 24 2021
Journal Name
Journal Of Research In Medical And Dental Science
Efficacy of Oregano Essential Oil Mouthwash in Reducing Oral Halitosis: A Randomized, Double-Blind Clinical Trial
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Efficacy of Oregano Essential Oil Mouthwash in Reducing Oral Halitosis: A Randomized, Double-Blind Clinical Trial, Mohamed Saeed M Ali, Ayser Najah Mohammed*

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Publication Date
Fri Dec 26 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of dental arches symmetry in a sample of Iraqi children at the mixed dentition stage
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Background: Little is known about asymmetry of children's dental arches, the purpose of this study was to verify the presence of asymmetry of dental arches among Iraqi children in the mixed dentition stage. Materials and methods: The sample included 52 pairs of dental casts, 27 pairs belong to males and 25 pairs for females. Three linear distances were utilized on each side on the dental arch: Incisal-canine distance, canine-molar distance and incisal-molar distance, which represent the dental arch segmental measurements using the digital sliding calipers, which is accurate up to 0.02 mm. Results: No significant sides' differences with high correlation coefficient were found between the right and left incisal-canine, canine-molar and in

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Publication Date
Mon Apr 15 2002
Journal Name
Alustath Journal For Human And Social Sciences
The Intersectionality in I've Been Meaning to Tell You: A Letter to My Daughter: A Post-Colonial Perspective
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Intersectionality is a concept that focuses on social inequality towards black people and provides an analytical instruments for creating social justice issues in such a way in order to depict how social marginalization, or privilege occurs differently in various social positions. It does this by focusing on the interaction of multiple systems of oppression. Intersectionality is used to examines how the social factors; race, gender, and class can affect the people’s life especially the immigrants, black people, and refuges. This article will depicts how blacks in Canada are segregated and distinguished from white race. David Chariandy’s I’ve Been Meaning To Tell You: A Letter to My Daughter 2018 is analyzed through Kimberle Crenshaw

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Publication Date
Fri Apr 15 2022
Journal Name
Alustath Journal For Human And Social Sciences
The Intersectionality in I’ve Been Meaning To Tell You: A Letter to My Daughter: A Post-Colonial Perspective
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Intersectionality is a concept that focuses on social inequality towards black people and provides an analytical instruments for creating social justice issues in such a way in order to depict how social marginalization, or privilege occurs differently in various social positions. It does this by focusing on the interaction of multiple systems of oppression. Intersectionality is used to examines how the social factors; race, gender, and class can affect the people’s life especially the immigrants, black people, and refuges. This article will depicts how blacks in Canada are segregated and distinguished from white race. David Chariandy’s I’ve Been Meaning To Tell You: A Letter to My Daughter 2018 is analyzed through Kimberle Crenshaw

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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
The Role of Satellite Channels in Imparting Behavior to Children from the Point of View of their Parents in Tulkarm City
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This study aims to identify the role of satellite channels in imparting behavior to children from the point of view of their parents in Tulkarm city. The researcher used a descriptive technique. A sample of (18000) males and females married couples was used above 20 years old in the city of Tulkarm. The study sample size is (201) married couples. It took place in September 2020. The questionnaire was the main tool for collecting data. The study found that the total degree of satellite channels contribution in imparting negative behaviors to children was high, as it reached (72.20%). The total degree of the role of satellite channels in imparting positive behaviors to children was medium, reaching (69.20%). Moreover, the results also indi

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Publication Date
Thu Apr 20 2017
Journal Name
International Journal Of Science And Research (ijsr)
Learning Styles according to the Model of Felder & Silverman and its Relationship with Mathematical Self-perceived Efficacy to Students of the College of Education for Pure Sciences-Ibn Al-Haitham
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This research aims toknow the learning styles according to the model of Felder and Silverman and its relationship to effectively self- perceived mathematicalamong students of the Faculty of Education Pure Sciences - Ibn al-Haytham. By answering the following questions: 1. What are the preferred methods of learning among students in the mathematics department according to the model Felder and Silverman? 2. What is the mathematicalself-perceived levelof the students at the Department of Mathematics effectiveness level? 3. What is the relationship between learning styles according to the Felder model and Silverman and the effectiveness of mathematical self-perceived of the students of the Department of Mathematics? The research sample consiste

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Publication Date
Sun Oct 07 2018
Journal Name
Al-kindy College Medical Journal
Risedronate as a therapeutic trial post-hysterectomy in premenopausal women to prevent osteoporosis
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Background: Osteoporosis is a skeletal defect manifested by a reduction of bone strength as a result of reduced bone mass to the extent that there is a higher risk of fracture even on minor trauma. Hysterectomy in a premenopausal woman is a well known cause of ovarian failure resulting in an increased risk of osteoporosis.

Objective : To clarify bisphosphonate's preventive effect on osteopenia and osteoporosis in premenopausal women after hysterectomy.

Type of the study: Cross –sectional study.

Method:  84 premenopausal females post hysterectomy aged between 40 – 50 years, were enrolled in this randomized controlled double blinded trail a

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Publication Date
Sat Jul 02 2016
Journal Name
Iraqi Medical Journal
Screeing for Hepatitis ( HBs Ag) and Hepatitis C (HCV Ab) Among Dialysis Children.
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Publication Date
Mon Oct 06 2014
Journal Name
Journal Of Educational And Psychological Researches
Impulsive behavior among Kindergarten children and its relation ship with some variables preparation
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Quite anumber of parents and educators of this behavior,which is characterized by exaggerating locomotor activity and impulsivity and recklessness and the difficulty of continuing the status of certain bodily more than one minute ,and the difficulty of waiting to meet aparticular need or desire,it also characterized by thos meddling children the affairs of others and increased their  chatter does not seem the case when you listen to talk to them and they characterized by  weak self-confidence and are more solid and seem un able to keep ther responses because of the severity of anxiety .The research aims to know impulsive behavior among kindergartens children and its relation ship with some variables, and the sa

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Publication Date
Tue Jun 01 2021
Journal Name
Ibn Al- Haitham Journal For Pure And Applied Sciences
Gene Expression of NLRP3 Inflammasome in Celiac Disease of Iraqi Children
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Celiac disease (CD) is an autoimmune disorder characterized by chronic inflammation that essentially affects the small intestine and is caused by eating gluten-containing foods. This study sought to determine gene expression of NLRP3 Inflammasome in peripheral blood of Iraqi CD children using quantitative real-time PCR (qRT-PCR) assay. Thirty children with CD (12 males and 18 females) were enrolled in the study and their age range was 3-15 years. The diagnosis of the disease was confirmed by serological examinations and intestinal endoscopy. A control sample of 20 age-matched healthy children was also included. The children were stratified for age, gender, body max index (BMI), histological findings, and marsh classification. Furthe

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