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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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Tue Sep 08 2026
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Tue Oct 06 2026
Journal Name
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The study of comparing the cognitive teaching method effect ( total and analytic ) in teaching the counter- attack of Epee
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The research's aim is to place two teaching methods ( total and analytical method) and to know which one of them is better than the other in teaching the counter-attack with Epee. The researchers have used the experimental method for being considered suitable to solve the problem of the research. The sample of the research includes third –stage female students of college of physical education and sport sciences / Baghdad University in the subject of fencing, their number amounted 60 female students. It has been used SPSS for processing the results. They have concluded that the two groups of the research and the two methods (( total and analytical) have learnt the counter- attack of the two over mentioned groups. they have recommended to c

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Sun Jan 01 2023
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Comparing the Design Alternatives Using Building Information Model (BIM) and Constructability in Iraqi Construction Projects
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The Iraqi construction industry suffers from many issues that lead to many design errors, clashes, delays and cost overruns. Therefore, applying constructability will prevent these issues from happening, as it has proven its positive effect in different projects around the world. The goal of this paper is to use building information modelling (BIM) to assess the constructability, provide the opportunities for the project stakeholders to choose the best constructable design alternative and find the affection of applying constructability on project cost. The practical side of this research consists of two parts: in the first part, 37 factors are collected from the literature review as factors that effect on constructability. After tha

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Publication Date
Sun Feb 01 2015
Journal Name
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The Relationship between Growth and Economic Reformation in Iraq: Post 2003
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There were many ideas and opinions on the linkage between growth and economic reform  in both developed and developing countries. The relationship is, of course, existed. Therefore, this research comes to analyses it in the Iraqi economy. This study is based on a hypothesis that the economic reformation in Iraq leads to lag level of growth with the of high rates of inflation. However, the study is designed to be included five sections. It found a positive relationship between the economic reformation and slowing of economic growth, in which the specified hypothesis is not fit to the economic reality in Iraq after 2003                  &

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Publication Date
Wed Jun 30 2021
Journal Name
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Management by roaming and self-efficacy and their impact on the excellence of hotel service: An applied study
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Publication Date
Mon Sep 28 2026
Journal Name
Iraqi Journal Of Pharmaceutical Sciences
The Impact of Infliximab Trough Level and Anti-Drug Antibody on Clinical Outcomes in Crohn's Disease Patients: A Cross-Sectional Study in Iraq
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Publication Date
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Recently, it has been revealed that Toxoplasmosis may be associated with some factors related to type 2 diabetes, such as glucose, insulin, the Homeostatic Model Assessment for Insulin Resistant (HOMA-IR), and Fatty acid binding protein (FABP). Therefore, the current study aimed to specify how Toxoplasma gondii (T.gondii) infection affects glucose, insulin, HOMA-IR, and FABP among adolescents. From October to December 2022, this study was carried out at Al Madain Hospital in Baghdad. For a group of adolescents visiting the hospital, an ELISA test was performed to check their anti-T.gondii antibodies. Ninety adolescents were selected to participate in the study on the basis of this examination. They were divided into two groups: those who te

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Nutritional Status of Pregnant Adolescents in Baghdad City
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Publication Date
Mon Mar 07 2022
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The impact of the Roundtable and Self-Questioning strategies on achievement and self-efficacy For students of the Faculty of Education in the subject of research curricula
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Tue Jan 19 2021
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Post-fire serviceability and residual strength of composite post-tensioned concrete T-beams
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