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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
Mon Nov 10 2025
Journal Name
Sciences Journal Of Physical Education
Using two types of electronic questions by applying the Quiz Creator program in the method of guided discovery and its effect on learning and maintaining a motor chain on the throat
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Publication Date
Sat Apr 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
The Effect of Vitamin B9 and E on the Yield and Its Components of the Wheat Crop
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Abstract<p>During the 2016–2017 and 2017–2018 winter semesters, researchers from the College of Agricultural Engineering Sciences at the University of Baghdad conducted a field experiment at the university’s research station. This inquiry set out to examine how spraying wheat plants with vitamins B9 (Folic acid) and E (Tocopherol) affected certain yield characteristics (Al-Fourat variety). The studies were set up as three repetitions of a factorial experiment using a Randomized Full Block Design. Vitamin E was sprayed at 0, 1, and 2 ml.L<sup>-1</sup>, while vitamin B9 was sprayed at 0, 1, and 3 ml.L<sup>-1</sup> (0, 250, and 500 mg. L<sup>-1</sup>). While the </p> ... Show More
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Publication Date
Thu Jun 09 2016
Journal Name
Journal Of The College Of Basic Education
Study the effect of Thymus vulgaris on the weight of Liver and Kidneys in Albino male rats
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Wed Jun 30 2021
Journal Name
Iraqi Geological Journal
The Effect of Weighting Materials on the Rheological Properties of Iraqi and Commercial Bentonite in Direct Emulsion
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Numerous drilling additives and materials are used continuously because they are necessary to support and give the required properties of the drilling fluid so that to ensure the stability of the borehole. This paper aspires to evaluate the rheological properties of bentonite (montmorillonite) Trefawey as an alternative to using commercial bentonite. Monitoring and evaluating of the rheological and filtration properties were prepared. This exertion aims to focus on the effect of hematite, and barite on the rheological properties of the three aforementioned bentonite types. An improvement in the rheological properties of bentonite (montmorillonite). Trefawey was observed after adding the previous heavy materials. Hematite has by some

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Publication Date
Thu Mar 01 2018
Journal Name
Nauchforum
THE PROBLEM OF TRANSLATING METAPHOR IN AN ARTISTIC TEXT (ON THE MATERIAL OF RUSSIAN AND ARABIC LANGUAGES)
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Wed Jul 01 2015
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Al–bahith Al–a'alami
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Publication Date
Sun Jan 02 2022
Journal Name
Journal Of The College Of Languages (jcl)
The Effect of Genderism on the Process and the Product of Translation
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    Many studies have been made and still concerning the field of translation. Since the mid-90's a considerable amount of researches has tackled the problem of gender and its effect on the process and the product of translation. Simon (1996, p 508) points out that when comparing women and men as translators and writers through history, women seem to be the weaker side. This paves the way to feminist movements which produce prominent studies concerning gender as a concept and translator's gender as practice on the quality and the accuracy of the translation.           

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Wed Feb 15 2017
Journal Name
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Effects of Ionized Water on Certain Egg Quality Traits and the Levels of Proteins and Enzymes in the Blood of the Japanese Quail Coturnix japonica
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Objective: This experiment was conducted to study the effects of ionized water on certain egg quality traits and the levels of proteins and enzymes in the blood of the Japanese quail Coturnix japonica . Materials and Methods: One hundred 42-day-old quail were randomly distributed among five treatment groups with four replicates for each group. The following treatments were used: T1 (control): The birds were provided normal water, T2: The birds were provided alkaline water (pH = 8), T3: The birds were provided alkaline water (pH = 9), T4: The birds were provided acidic water (pH = 6) and T5: The birds were provided acidic water (pH = 5). A Complete Randomized Design (CRD) was used to investigate the effects of the studied treatments on diffe

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Publication Date
Thu Jan 01 2015
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Journal Of Traumatic Stress Disorders &amp; Treatment
Randomised Controlled Study Comparing Two Psychological Therapies for Posttraumatic Stress Disorder (PTSD): Emotional Freedom Techniques (EFT) vs. Narrative Exposure Therapy (NET)
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Publication Date
Sun Jun 27 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Quality of Nursing Care Services Provided to Children under Five Years Based on Integrated Management of Child Health at Primary Health Care Centers in Baquba City
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Objective(s): The study aims to evaluating the quality of nursing care provided to children under five years to compare between quality related to type of health sectors; to determine the quality of nursing care and to compare between such care in Baquba Health Care Sector I and II.

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