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bijps-974
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
Thu Dec 15 2022
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Art as a therapy to relieve symptoms of Attention Deficit/Hyperactivity Disorder (ADHD), in children
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The aim of the present study is to evaluate the effectiveness of using Art as therapy to reduce the symptoms of Attention Deficit Hyper Activity Disorder (ADHD), in primary school children.
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Mon Nov 10 2025
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Maximum bite force among a group of Iraqi children in relation to mandibular growth rotation
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Sun Jan 05 2020
Journal Name
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THE EFFECT OF THE TRAINING CURRICULUM ON DEVELOPING KINETIC AND TRANSITIONAL RESPONSE SPEED, ACCURACY OF THE STOPPING WALL PERFORMANCE, AND DEFENDING THE STADIUM IN VOLLEYBALL
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Thu Sep 01 2011
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The relationship between organizational justice and empowerment and their impact on achieving organizational commitment (field study in the Department of Labor and Vocational Training)
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The research has deal with the relationship between organizational justice and empowerment and their impact on the achievement of organizational commitment in the office of Labour and Vocational Training. To study the research problem which is represented a sense that employees with low levels of organizational justice and empowerment and the reflection on the organizational commitment of the employees, so that Has been collecting data and information relating to research by designing a questionnaire, were distributed to a sample of (50) people in the office mentioned, and the results of the study to confirm the research hypotheses. and the key results of the research was the presence of correlation relationships and the effect o

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Mon Mar 01 2010
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Journal Of Economics And Administrative Sciences
Measuring and analyzing the effect of labor productivity and capital on manufacturing industries in Iraq and some Arab countries for the period 1990-2000
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Mon Nov 10 2025
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Periodontal condition in relation to nutritional status among kindergarten children in Al-Ramadi city/Iraq
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Background: Nutrition can affect periodontal disease through contributing to microbial growth in the gingival crevice, affecting the immunological response to bacterial antigens and assisting the repair mechanism of the connective tissue at the local site after injury from plaque and calculus. The aim of this study was to assess the prevalence of Oral hygiene (plaque and calculus) and gingivitis in relation to age, gender and nutritional status. Materials and methods: The sample included (444) kindergarten children at age of (4 and 5 years old) males and females from urban areas in Al-Ramadi city. The assessment of nutritional status was performed using anthropometr

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Mon Nov 10 2025
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Publication Date
Sun Dec 31 2023
Journal Name
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The relationship between the rule of mental improvement and ugliness and the objectives of Sharia And its impact on rulings
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The research addresses a fundamental Islamic jurisprudential Purposeful issue, which is (Sharia), and to indicate the impact of this on Islamic jurisprudence, deriving rulings and extracting purposes, and to repel the illusion that this issue is only doctrinal, and clarifying the aspects of similarities and links between them by explaining the origin of deriving the purposes of Islamic Law (Sharia) through the meanings and wisdom learned from the texts and the explanation of the rulings. The rulings of Islamic Law (Sharia) have urged bringing benefits and repelling harms, and that the path to do so is reason and its production. I began the research by defining the purposes of Islamic Law (Sharia), then defining the rule of rational right

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The effect of aqueous crude extract of ginger on the histology of corpus luteum and the concentration of hormones estrogen and progesterone in pregnant mice
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Publication Date
Sun Dec 15 2019
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Maximum bite force in relation to maximum mouth opening among primary school children
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Background: The vertical distance between the upper and lower incisal edge of the central incisors when the mouth is opened as wide as possible is called maximum mouth opening (MMO). Any pathological change in the masticatory system had a direct effect on the maximal mouth opening. The aim of this study was to evaluate the relationship between the maximum bite force and the maximum mouth opening among group of children. Materials and methods: Four hundred children of both genders were included in this study, their age ranged from eight to ten years. Anterior and posterior (right, left) bite force were measured using bite force sensor. Maximum mouth opening was evaluated by electronic digital caliper. Data was statistically analyzed

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