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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 Jul 25 2026
Journal Name
Al-fatih Journal
Development of explosive power training with weights in a way the ups and downs and its impact on the improvement of some variables Albyukinmetekih and technical performance of the skill of a leap forward on your hands vaulting modern
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Thu Sep 15 2022
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Alustath Journal For Human And Social Sciences
The Impact of Mind and Informational Strategy on the ‎Achievement of the Second Intermediate Students in the Grammar ‎of Arabic Language
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The aim of the current research is to recognizing the impact of mind and informational strategy on the achievement with the second intermediate students in the grammar of arabic language, the researcher used a partial-set experimental design and intentionally selected a sample out of the second intermediate class from (AL- Markazya Intermediate school) in the district of Hilla, affiliated which belongs to General Directorate of Babylon Education in the year (2020-2021) for applying the experiment. The sample was composed of (50) students, (25) ones for each group, the experimental group and normal one. The researcher balanced between the two groups in various changes including: (the chronological age counted by months, the academic achie

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
information and communication technologies and their impact on changed the financial reporting system In a Sample in Iraqi banks
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Fri Jun 01 2018
Journal Name
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Publication Date
Fri Jun 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Oral Health Status among 9 years old school Children in Al-Diwaniyah City/Iraq.
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Publication Date
Mon Dec 31 2018
Journal Name
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THE EFFECT OF ALCOHOLIC EXTRACT OF Borage officinalis ON MONOAMINE OXIDASE (MAO) AND ACETYLCHOLINESTERASE (AChE) IN HUMAN SERUM IN VITRO.: THE EFFECT OF ALCOHOLIC EXTRACT OF Borage officinalis ON MONOAMINE OXIDASE (MAO) AND ACETYLCHOLINESTERASE (AChE) IN HUMAN SERUM IN VITRO.
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This study was designed to show the inhibitory effect of different concentrations of alcoholic extract of Borage officinalis on the Monoamine oxidase (MAO) and Acetylcholinesterase (AChE) enzymes in human serum. The results obtained from the study exhibited that alcoholic extract of Borage officinalis caused inhibition to enzymes activity with all concentrations of the extract. The results also showed that when the concentration of the extract was (0.001 mg/ml), the percentage of inhibition was (4.3% with MAO and 15.2% with AChE) and this percentage increases until reaching up to (74.7% with MAO and 84.18% with AChE) when the concentration of the extract was (0.1 mg/ml). From the kinetic parameters, studies found that alcoholic extract o

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Thu Mar 15 2018
Journal Name
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The Study of Oral Findings, Oxidative Stress and Antioxidant Vitamin E in Serum and Saliva of Crohn's Patients on Azathioprine Monotherapy and those on Combination of Anti-TNF-α Plus Azathioprine
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Background: Crohn's disease (CD) is an immunological disorder associated with chronic inflammatory process of several unspecific regions of gastrointestinal tract but frequently detected in the terminal Ilium and proximal colon or both. This disease frequently presented with various oral manifestations as a consequence of inflammatory process of the disease, nutritional deficiency or medications side effects. Several therapeutic approaches have been developed for CD management that are targeting the inflammatory process and directed at controlling the host immune response. Immunosuppressants such as Azathioprine and anti-TNF α agents as well as the combination of them have been widely used as an effective therapeutic modality with a bett

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