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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
Sat Sep 20 2025
Journal Name
Journal Of Baghdad College Of Dentistry
An Oral Health Status and Treatment Needed in Relation to Dental Knowledge, Among a Group of Children Attending Preventive Department, College of Dentistry, University of Baghdad
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Background: Oral health represents an important base for human well-being; the heath of the body begins from oral cavity. Great deal has been applied to increase knowledge in the field of oral health in order to develop appropriate preventive program. This study was conducted in order to estimate the percentage and severity of dental caries and gingivitis among children attending Preventive Department in Collage of Dentistry, University of Baghdad and to determine dental treatment need for those patients, further more to study the relation of these variables with dental knowledge. Materials and Methods: The study group consists of 163 children with an age ranged from 6 to 14 years, who attended the preventive clinic for the first time to be

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Publication Date
Sun Jun 10 2018
Journal Name
Annals Of Clinical And Analytical Medicine
Lead among children with autism in Iraq. Is it a potential factor?
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Abstract Aim: Autism is a neurodevelopmental disorder which affects communication and social interaction of children. It is a heterogeneous disease with various clinical presentations. Some genes are involved in its pathogenesis. It has been suggested that environmental exposure to lead can increase the risk of autism. The aim of our study was to compare blood lead levels among autistic and non-autistic children. Material and Method: This retrospective study included 107 children (60 with autism and 47 without autism) referred from the different Iraqi provinces, in the years 2015, 2016 and 2017, to the poisoning consultation center in Baghdad. Data collection including age, gender, residence, referral source, family history and blood lead l

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Publication Date
Wed Sep 25 2024
Journal Name
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Maximum mouth opening measurement in relation to maximum bite force among children
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Objective: This research aimed to study the relation between maximal bite force (MBF) and maximum mouth opening among 12-year-old school children. Methods: In this cross-sectional study, a total of 400 children aged 12 years (194 boys and 206 girls) were examined. The MBF for the right and left side, as well as the anterior region, were evaluated for all children. The MMO was measured using an electronic digital caliper. To analyze the data path analysis method was used. Results: Boys showed a higher MMO of 48.797 ± 6.500 than girls (46.710 ± 5.926 mm). The MMO increased with increasing MBF, with significant differences between females and males. Conclusion: The MMO was higher in boys than in girls. Gender plays a significant ro

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Publication Date
Fri Mar 28 2025
Journal Name
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The effect of the four-pillar strategy on the performance of the transmission and preparation skills in volleyball
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The aim of the research is to prepare practical volleyball lessons by using the four pillars strategy for middle school students, and to identify the effect of the four pillars strategy in performing the transmission and volleyball skills in the second intermediate students, to assume that the two researchers assume that there are no statistically significant differences between the results of my skill performance tests Sending and preparing tribal and remote volleyball for the experimental and controlled groups, and there are no statistically significant differences between the results of the performance of the transmission and preparation skills of the volleyball between the two experimental and control groups, and the research co

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Sat Sep 20 2025
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Cognitive bias and its relationship to the performance of the two skills of standing on (hands and the human wheel) on the floor movement carpet device in the artistic gymnastics for women
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Fri Dec 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
The Effect of Power Sources in the Agricultural Tractor and the Developed Sprayer System on the Performance of the Electrical and Mechanical Sprayer System and some Performance Indicators of the Engine
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Wed Apr 01 2020
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The Effect of Using Resistance and Medical Ozone Training on Testosterone and Some Physiological Variables in Swimmers
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Publication Date
Tue Dec 31 2019
Journal Name
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The Effect of Disclosure and Transparency Criteria In Saudi Banks on The Financial Ratios Indicators
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The study aimed to measure the effect of applying the disclosure and transparency standards criteria adopted by the Saudi Arabian Monetary Authority on improving performance indicators in the Saudi banking sector, by measuring the extent of the impact of the bank's financial indicators represented by liquidity, profitability and return on assets in Saudi banks by applying the criteria of disclosure and transparency, which is one of the Main principles in the list of governance, which was approved by the Saudi Arabian Monetary Authority. The analytical approach was followed to achieve the goal of the study, as the financial statements of Saudi banks were analyzed during a period of 8-year to test four hypotheses related to measuri

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Publication Date
Sun Jun 06 2010
Journal Name
Baghdad Science Journal
The effect of wastewater disposal on the water quality and phytoplankton in Erbil wastewater channel.
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In this study, phytoplankton density, chlorophyll-a, and selected physico- chemical parameters were investigated in Erbil wastewater channel. The surveys were carried out monthly from May 2003 to April 2004. Samplings were established on three sites from headwaters to the mouth. The results showed that pH was in alkaline side of neutrality, with significant differences (P<0.05) between sites 1 and 3. TSS concentration decreased from site 1 toward site 2 (mean value, 80.15 to 25.79 mg.l-1). A clear gradual increase in mineral content (TDS) observed from site one of the channel towards the mouthpart. Soluble reactive phosphate has a concentration maximum mean value reached 48.4 µg.l-1 which is recorded in site 2. A high positive relat

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Publication Date
Sun Jun 05 2022
Journal Name
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Visual spatial attention and its impact on the accuracy of the diagonal spike in volleyball
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The primary aim of this research was to study visual spatial attention and its impact on the accuracy of the diagonal spike in volleyball. A total of 20 volleyball players of Baghdad participated in this study. The sample was homogeneous in terms of height, weight and age of the players. The tests used in the present study were: 1) Visual Spatial Attention Test. 2) Volleyball Spike Test. Based on the findings of the study, the researcher concluded that visual spatial attention has a significant impact on the accuracy of the diagonal spike in volleyball.

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