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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
Wed Oct 22 2025
Journal Name
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This study evaluates the flexural behavior of ultra-thin (50 mm) one‑way reinforced‑concrete (RC) slabs retrofitted with near‑surface mounted (NSM) carbon‑fiber‑reinforced polymer (CFRP) rods under quasi‑static loading. T300‑grade CFRP rods (≈4 mm diameter) were bonded in pre‑cut 7 mm × 7 mm grooves using a two‑part epoxy. As a proof-of-concept experimental baseline, three simply‑supported specimens (1000 mm × 500 mm × 50 mm) were tested in a six‑point bending configuration (four applied loads + two reactions): two conventional controls and one strengthened slab. A load‑control rate of ~15 kN/min was applied; the controls were cycled twice and the strengthened slab four times. Relative to the average of

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Sun Mar 06 2022
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The Use of Social Networking sites in the Marketing of Values Analytical : Study of the Official Pages of the Ministry of Culture, Tourism and Antiquities and the Ministry of Labor and Social Affairs on Facebook
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The social networking sites have brought about fundamental changes and a qualitative shift in the marketing industry and its strategies. The Iraqi ministries have used this site i.e. Facebook to spread and disseminate values in order to consolidate it in Iraqi society which has witnessed many changes in all aspects of life.

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Wed Jul 01 2015
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Article The reality of the settlements in the occupied West Bank, and its impact on the future of the Palestinian state
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الخلاصة

تتناول هذه الورقة مخططات وسياسات الاستيطان في الضفة الغربية والقدس الشرقية منذ العام 1967، عبر سياسات قادها حزب العمل وأكملها حزب الليكود وكاديما وبقية الأحزاب الإسرائيلية، تلك السياسات التي استهدفت فرض السيطرة السياسية الكاملة على الأرض، وما نتج عن ذلك من سيطرة حصرية على الأرضوتقييد استخداماتها، ومحاصرة الوجود الفلسطيني والتضييق عليه، وتحويل مراكز ال

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Fri Jan 01 2016
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Polymorphism of IL-4 -590 (C>T) gene in Iraqi children with Type 1 Diabetes Mellitus
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Fri Oct 30 2020
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