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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 Jan 18 2025
Journal Name
Al-anbar University Journal Of Law And Political Sciences
The Effect of E-Government on Public Facility Management Methods (Comparative Study)
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Publication Date
Fri Jan 01 2010
Journal Name
Ibn Al- Haitham J. Fo R Pure & Appl. Sci
Evaluation of The Nuclear Data on(α,n)Reaction for Natural Molybdenum
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The cross section evaluation for (α,n) reaction was calculated according to the available International Atomic Energy Agency (IAEA) and other experimental published data . These cross section are the most recent data , while the well known international libraries like ENDF , JENDL , JEFF , etc. We considered an energy range from threshold to 25 M eV in interval (1 MeV). The average weighted cross sections for all available experimental and theoretical(JENDL) data and for all the considered isotopes was calculated . The cross section of the element is then calculated according to the cross sections of the isotopes of that element taking into account their abundance . A mathematical representative equation for each of the element

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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
The effect of 5555 strategy on reading comprehension among 4th preparatory students
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The effect of 5555 strategy on reading comprehension among 4th preparatory students Assist. Prof. Dr. Hassan Khilbas Hammadi College of Education Ibn Rushd – The University of Baghdad Assistant Lecturer. Waleed Khaled Talib Directorate – General For Education Province Of AL - Anbar The purpose of study is to identify the effect of 5555 strategy on reading comprehension among 4th preparatory students. To do this, null hypothesis was postulated. The author hypothesize that there is no a statistically significant difference at (0.05) level between experimental group's scores who study reading comprehension subject following the 5555 strategy and control group's scores who study the same subject following the traditional method in readin

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Publication Date
Sat Jan 18 2025
Journal Name
Mathematical Theory And Modeling
Some Results on the Group of Lower Unitriangular Matrices L(3,zp)
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The main objective of this paper is to find the order and its exponent, the general form of all conjugacy classes, Artin characters table and Artin exponent for the group of lower unitriangular matrices L(3,? p ), where  p  is prime number.

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Publication Date
Thu Jun 01 2023
Journal Name
Journal Of Engineering
The Effect of Rubber Crumbs on Marshall Properties for Warm Mix Asphalt
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A new pavement technology has been developed in Highway engineering: asphalt pavement production is less susceptible to oxidation and the consequent damages. The warm mix asphalt (WMA) is produced at a temperature of about (10-40) oC lower than the hot asphalt paving. This is done using one of the methods of producing a WMA. Although WMA's performance is rather good, according to previous studies, as it is less susceptible to oxidation, it is possible to modify some of its properties using different materials, including polymers. Waste tires of vehicles are one of the types of polymers because of their flexible properties. The production of HMA, WMA, and WMA modified with proportions of (1, 1.5, and 2%) of rub

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Publication Date
Wed Jan 01 2020
Journal Name
Fme Transactions
Development of automated liquid filling system based on the interactive design approach
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The automatic liquid filling system is used in different applications such as production of detergents, liquid soaps, fruit juices, milk products, bottled water, etc. The automatic bottle filling system is highly expensive. Where, the common filling systems required to complex changes in hardware and software in order to modify volume of liquid. There are many important variables in the filling process such as volume of liquid, the filling time, etc. This paper presents a new approach to develop an automatic liquid filling system. The new proposed system consists of a conveyor subsystem, filling stations, and camera to detect the level of the liquid at any instant during the filling process. The camera can detect accurately the leve

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Publication Date
Thu Oct 01 2020
Journal Name
Engineering Science And Technology, An International Journal
Thermal performance improvement based on the hybrid design of a heat sink
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Publication Date
Sun Dec 01 2002
Journal Name
Iraqi Journal Of Physics
Study of Gamma — irradiation effects on the Polymethylmethacrylate (PMMA) Using (PAL) Method
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Gamma - irradiation effect on polymethylmethacrylate (PMMA) samples has been studied using Positron Annihilation Lifetime (PAL) method. The orthopositronium (o-Ps) lifetime τ3, hence the o-ps parameters, the volume hole size (Vh) and the free volume fraction (Ꞙh) in the irradiated samples were measured as a function of gamma-irradiation dose up to 28.05 kGy. It has been shown that τ 3, Vh, and Ꞙh, are increasing in general with increasing gamma-dose, to reach a maximum percentage increment of 22.42% in τ3, 60% in Vh and 29.5% in Ꞙh, at. 2.55 kGy, whereas τ2 reaches maximum increment of 119. 7% at 7.65 kGy. The results s

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Publication Date
Thu Oct 06 2022
Journal Name
2022 9th International Conference On Electrical Engineering, Computer Science And Informatics (eecsi)
On the Performance of a Composite Right Left Hand Electromagnetic Bandgap Structure
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This paper presents the design and analysis of composite right left hand (CRLH) electromagnetic bandgap (EBG) structure. The proposed unit cell is consistent of a dielectric substrate with dimensions of 5×5×1 mm 3 made of FR4-Epoxy with εr = 4.4 underneath of a conductive patch with dimensions of 4.4×4.4mm 2 . The unit cell is structured to perform a negative permittivity (ε) and negative permeability (µ) in different bands. The proposed unit cell is developed to 5G systems in the sub-6GHz bands. In this work, a complete analysis of the unit cell in terms of Sparameters, constitutive parameters and refraction index are evaluated using HFSS simulation package based on Finite Element Method (FEM).

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Publication Date
Wed Sep 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of Upper Removable Orthodontic Appliances on Oral Candidal Mucosal Carriage
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Background: Treatment of malocclusions using removable orthodontic appliances may prepare new stagnant areas susceptible for colonization and retention of Candida species, therefore; the aim of this study was to investigate the effect of upper removable orthodontic appliances on the mucosal Candidal count in group of apparently healthy orthodontic patients. Materials and Methods: Patients enrolled in this study were children aged 8-12 years having upper removable orthodontic appliances. Candidal counts at six mucosal sites were estimated using Imprint Culture method before, 14 and 28 days during orthodontic therapy. Results: Whole mouth and individual mucosal sites for Candidal counts increase significantly during treatment with upper remov

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