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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
Thu Oct 01 2026
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
Mon Jun 05 2023
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Knowledge Upgrading on Business Continuity:A Field Research in Private Colleges and Universities in Baghdad
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The research aims to study the effect of knowledge upgrade on business continuity in private colleges and universities in Baghdad. The research problem is summarized in the main question (were the academic leaders able to employ knowledge upgrading to enhance business continuity). The most important of this sector were the universities and the private college in the city of Baghdad as a field for this research, the researchers conducted a field visit to (10) universities or private colleges, the research sample consisted of (177) individuals from the deans of colleges and their assistants, as well as heads of scientific and administrative departments. The data was analyzed and the hypotheses were tested using the appropriate statistical

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Publication Date
Mon Jun 28 2021
Journal Name
Journal Of Physical Education
The Effect of Electronic Apparatus on Developing Balance in National Center for Gifted in Boxing and Basketball
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The problem of the research lies in special motor abilities training programs like the balance that positively affect coordination between the nervous system and muscles. These training programs did not get enough attention from athletes especially young athletes; their training was restricted to physical abilities like strength, speed, and endurance instead. The research aimed at designing an apparatus for developing athletes’ balance in national centers for gifted/ ministry of youth and sport so as to provide a measurement for coached in this field. The results showed that the designed apparatus have a positive effect on developing the subjects’ balance in boxing and basketball athletes.

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of The College Of Education For Women
The Impact of Anticyclones Merge on the Temperature in the stations of Mosul, Baghdad and Basra for the Period (2005-2015)
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Publication Date
Sun Mar 19 2023
Journal Name
Nasaq Journal
The impact of the Roundhouse strategy on the achievement of the fifth grade secondary school in physics and their pivotal thinking
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The aim of the research is to study the effect of the roundhouse strategy on the achievement of fifth grade secondary school in physics and their pivotal thinking. The experiment has been applied for obtaining the data, which were processed statistically using the Statistical Package for Social Sciences, the results revealed that the students of the experimental group who studied using the roundhouse strategy was superior to the students of the control group who studied in the traditional method in the achievement exam. The results also show that there are statistically significant differences between the mean scores of the students of the experimental group and the control group in the pivotal thinking exam, in favor of the experimental gr

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Publication Date
Fri Mar 31 2023
Journal Name
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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 Jun 03 2012
Journal Name
Baghdad Science Journal
Study the effect of the mixture aquatic extract of Peganum harmala seeds and Pericarp of Punica granutum on viability of protoscolices of Echinococcus granulosus in vitro and in vivo
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This study included the preparation of the mixture aquatic extracts of Peganum harmala seeds and Pericarp of Punica granutum at concentration (10+50) ?(15+55)? (20+60) mgml .To study the influence of the mixture on the percentage of vitality of the protoscolices of E. granulosus In vitro, as the vitality of protoscolices had caused complete death when the using concentration at time 120,90,60 minute respectively. Also study the effect of mixture in white mice with infectious protoscolices In vivo and study the change occurred in the averages of the weights of the liver and spleen and the averages of its distension In vivo in processed group with mixture at concentration (15+55) , (10+50)mgml ,as which was approach to the negative gro

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Publication Date
Fri Jul 01 2022
Journal Name
The Egyptian Journal Of Hospital Medicine
Evaluation of Adipokines Among Children Infected with Some Protozoan Intestinal Parasites
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Sun Dec 01 2002
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