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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
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The History of Multi Parties and its Effect on Political System in India
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The History of Multi Parties and its Effect on Political System in India

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Mon Apr 04 2022
Journal Name
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Constructing a Scale of Emotional Adjustment among Kindergarten Children
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The aim of the current research is to construct a scale of emotional adjustment for kindergarten children and to set a standard for its evaluation. To achieve this, a scale consisting of (19) items was prepared. The mother of the child answered by adopting the method of self-report, which is expressed in the form of reporting terms, as each item represents a situation in the child's life and each situation has three alternatives to answer that represent various responses to the mentioned situation. One of the alternatives represents the emotionally adaptive response, which is given a degree (3), the second response expresses the emotional adjustment partly that took the degree of (2), and the third response expresses the weakness of emot

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Publication Date
Thu Sep 26 2019
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Al-kindy College Medical Journal
Clinical Significance of Blastocystis Sp. among Children with Leukemia
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Background: Blastocystis spp. distributes world widely and the genus Blastocystis include many subtypes that are isolated from human intestinal tract. It is considered the most common parasite detected in human being.

Objectives: To evaluate the incidence of Blastocystis spp. among leukemic children, to find out its association with the presence of symptoms (diarrhea and abdominal pain), and to assess the efficacy of different staining methods in detection of Blastocystis spp. 

Type of the study: cross-sectional study.

Method: 103 children were enrolled in this study, 53 leukemic patients and 50 healthy con

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Publication Date
Sun Sep 30 2012
Journal Name
College Of Islamic Sciences
The fundamentalists' position on the absolute prohibition and its impact          In different jurisprudence
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Praise be to God, who started his book with the praise of himself and prayers and peace be upon those who have no prophet after him and his family and companions and those who followed them with charity until the Day of Judgment.
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Thu Jul 28 2022
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Experimental investigation on the damping characteristics in dry and saturated sands
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The topic of the research tagged (narrative structure and its impact on building open and closed endings in the fictional film) is summarized by studying the mechanism of employing closed and open endings in the fictional film. novelist, then the need for it, as well as the objectives of the research and clarifying its limits as well as its importance. Then moving to the theoretical framework, which included three topics, where the first topic was entitled (the cinematic construction of the film narrative), either the second topic (the structure of complexity and narrative solutions), or the third topic dealt with the subject (the structure of the end and its relationship to the construction of the narrative). After completing the theore

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Wed Dec 01 2021
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Expatriate Workers and Its Repercussions on the Economy and Labor Market in Iraq After 2003
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The demand for expatriate labor to Iraq increased after 2003 as a result of the openness that Iraq experienced, but this expatriate labor, which was requested at an increasing rate, has had economic, social, and political effects on the Iraqi economy in general, and the Iraqi labor market in particular. This is due to the high rates of unemployment, as most of these expatriate workers cause competition to local labor, and thus cause repercussions on the Iraqi economy as a whole, except for those expatriate workers coming with companies working in the oil sector. Iraq's GDP

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Developing the Skill of Friendship for Kindergarten Children in the Light of Bandura's Theory Social Learning: Ministry of Education / Baghdad Directorate of Education, Al/Rusafa
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Publication Date
Thu Jan 30 2020
Journal Name
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In vivo Study of Effects of Citric from Aspergillus Niger and Lemon Juice on the Hormonal Level and Histoarchitecture of the Testis
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To study the qualitative changes in testis tissue after carbon tetrachloride (CCl4) administration and to determine whether citric acid (CA) has a protective effect against testis damage induced by CCl4. This study compared two types of CA by measuring the histoarchitecture of the testis and serum levels of progesterone, estrogen and testosterone on mice. One of the most produced organic acid is citric acid. In this study, CA produced by microbial fermentation using Aspergillus Niger 5mg/kg and derived from citrus limon 400mg/kg (lemon). Mice were treated with daily intraperitoneal (i.p.) injection for seven successive days after randomly separated into six groups: (1) control, (2) CCl4 (0.02%), (3) limon citric acid (400 mg/kg), (4) CCl4 (

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Publication Date
Sun Feb 10 2019
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