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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 May 15 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
The Impact of Cigarette Smoking on Levels of Sex Hormones and Zinc in Blood of Smokers
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   Smoking has multiple effects on sex hormone , some of which are associated with important clinical implication .The present study was undertaken to  investigate the biochemical changes  of sex hormones associated with long standing cigarette smoking in 40 heavy smokers comparing with non- smoker and to correlate it with BMI for each .The sex hormones levels were determined by RIA  technique . Atomic absorption technique was used to measure the zinc levels.         The serum testosterone and estrogen levels of non – smoker group were 17.775ng\ml and 38.65ng\ml at p< 0.05, respectively .While the serum testosterone and estrogen levels of smoker group were 17.615n

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Publication Date
Sun Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Relational leadership and its effect on organizational energy (A comparative study in the Rafidain and Rashid banks)
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This research aims to test the relationship between "relational leadership as an independent variable and organizational energy as a dependent variable. The current research variables are among the recent and important variables for the development of organizations, and for the purpose of explaining the relationship and influence between the variables, a set of goals has been formulated, including providing the interested and scientific and theoretical information explaining the nature of the variables The research, and the extent to which its causes are reflected in the research sample to increase the interest of the research organization’s organization and make it more appropriate to the required performance in light of a cha

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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Weight Gain Post Treatment with Biological Compounds among A Sample of Patients Attending Baghdad Teaching Hospital
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Objective: to evaluate the increase in weight after biological agents and the association of weight gain with the body mass index among a sample of patients attending Baghdad Teaching Hospital Methods: A prospective study is carried out in Baghdad teaching hospital biological units and outpatient clinic of rheumatology for a period of one year starting On April 2015 and ending on March 2016. 120 patients were included in the study 40 psoriatic arthritis .40 ankylosing spondylitis and 40 rheumatoid arthritis Results : The study findings indicate that significance differences are seen regarding weight gain and b

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Publication Date
Sun Jul 13 2025
Journal Name
Journal Of Studies And Researches Of Sport Education
The effectiveness of the use of yoga exercises and its impact on the reactions of the two Alvesologih nervous and respiratory systems in the correction of antenna pistol shooting accuracy
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Publication Date
Thu Mar 30 2006
Journal Name
College Of Islamic Sciences
The novel of the innovator and its impact on the differences of jurists
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Praise be to God, Lord of the worlds, and prayers and peace be upon our master and beloved Muhammad, the wise guide and great teacher, the guide to a straight path, the one sent as a mercy to the worlds, and upon his good and chosen family, his chosen companions, the working scholars, and those who follow them in righteousness until the Day of Judgment.

And after:

One of the important controversial topics shared between the sciences of the Noble Hadith and the Fundamentals of God is the issue of the innovator in terms of accepting and rejecting his narration and testimony, and the difference in it leads to disagreement in many branches of jurisprudence that were based on texts narrated by innovated narrators or those accu

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Publication Date
Fri Mar 31 2023
Journal Name
Oncology And Radiotherapy
The Effect of Green Low Laser (LLL) on the white blood cells on platelet on people on brain and prostate cancer
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The effect of Low-Level Laser (LLL) provided by green semiconductor laser with an emission wavelength of 532 nm on of human blood of people with brain and prostate cancer has been investigated. The effect of LLL on white blood cell (WBC), NEUT, LYMPH and MONO have been considered. Platelet count (PLT) has also been considered in this work. 2 ml of blood sample were irradiating by a green laser of the dose of 4.8 J/cm2. The results suggest a potential effect of LLL on WBC, PLT, NEUT, LYMPH, and MONO of people with brain and prostate cancer Key words: white blood cell , platelet , low-level laser therapy

Publication Date
Sun Sep 30 2012
Journal Name
College Of Islamic Sciences
The Authority and its impact on the prevention of Sharia rulings
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Praise be to God, Lord of the worlds, and prayers and peace be upon our master Muhammad and upon his family and companions.
And after:

      Muslim scholars have fought in the extent of regard to these interests, each according to his opinion and according to his evaluation, and his consideration of this interest, but it remains important that the legislation in them needs more precaution and caution against the predominance of passions, because the passions often decorate spoilers so they see an interest, so practical application must To realize the spirit of Islamic Sharia in its entirety of its rulings, and the preponderance between the interests and evils that prevail in our societies, which c

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
The elements of the global tolerance and its impact on peace
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The achievement of world peace is a humanitarian demand that humanity has sought since its existence. Despite the international and regional efforts to achieve this demand, it is still reaching its desired ambitions if conflicts, contradictions, and internal and external wars continue to justify us clearly in terms of ethnic, religious and sectarian conflict. The revolution of informatics and the impact of globalization opened a new era of communication and openness and the negative and positive impact of others, which re-published and distributed values, ideas and new cultures Some of them carries extremist ideas urging violence and destruction and other abolition, it became necessary to follow policies and reward The culture of peace,

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Publication Date
Thu Dec 31 2015
Journal Name
Al-khwarizmi Engineering Journal
The Influence of Design and Technological Parameters on the MAF Process
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Abstract

 Experimental work from Magnetic Abrasive Finishing (MAF) tests was carried out design parameters (amplitude, and number of cycle which are formed the shape of electromagnetic pole), and technological parameters (current, cutting speed, working gap, and finishing time) all have an influence on the mechanical properties of the surface layer in MAF process. This research has made to study the effect of design and technological parameters on the surface roughness (Ra), micro hardness (Hv) and material removal (MR) in working zone. A set of experimental tests has been planned using response surface methodology according to Taguchi matrix (36) with three levels and six factors

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Publication Date
Fri Jan 01 2021
Journal Name
Aip Conference Proceedings
The effects of devitrification on the lithium glass surface and microstructure
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