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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 Jun 02 2011
Journal Name
Вестник Воронежского государственного университета. Серия: Лингвистика и межкультурная коммуникация
direct and indirect nomination in single-component characteristics...
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Publication Date
Mon Mar 27 2023
Journal Name
Recent Progress In Science And Technology
Recent Progress in Science and Technology Vol. 8
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Publication Date
Tue Jan 01 2019
Journal Name
Open Access Journal Of Chemistry
Gas Storage and Separation in Metal Organic Frameworks
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Publication Date
Sun Jun 01 2008
Journal Name
Al-khwarizmi Engineering Journal
Hydrodynamics, Mass and Heat Transfer in Reactive Distillation
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      The ethyl acetate synthesis via heterogeneous reactive distillation is studied experimentally using ethanol and acetic acid. Three types of cation exchanging resins were used as catalysts: Zerolit 225, Zerolit 226 and Ambylite 400. Experiments were carried out in two units of the same dimensions. Each unit consisted of three sections: rectifying, reactive and stripping sections of heights (60+25+20) cm respectively and 2.5cm column diameter. The first unit (column-A-) was a fractionation type and the second unit (column-B-) was packed column. The packing type was hollow glass cylinders with 10 mm height, and 4, 5 mm inner and outer diameter respectively.

      The experiment

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Tax Justice and its Effect in Tax Compliance
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Abstract

                 The research aims to verify the dimensions of tax justice that exist in Iraq, and to determine their impact on tax compliance. Through a revised model of tax justice based on the literature of tax justice according to the classification of the studies of (Saad, 2009), (Wenzel, 2002), by using a questionnaire as an experimental measurement tool designed to be in line with perceptions of tax justice in Iraq. To define the dimensions of tax justice (the independent variable) with eight dimensions (Distributive justice, Exchange justice, Vertical justice, Horizontal justice, Retributive justice,

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Discourse Markers in Political Speeches: Forms and Functions
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Discourse markers are expressions used to connect sentences to what comes before or after and indicate a speaker's attitude to what he is saying.As linguistic items, they have important functions in discourses of various styles or registers. And being connective elements, discourse markers relate sentences, clauses and paragraphs to each other. "One of the most prominent function of discourse markers, however, is to signal the kinds of relations a speaker perceives between different parts of the discourse". (Lenk 1997: 2) Through political discourse, different types of discourse markers are used. This paper deals with the importance and functions of discourse markers and tries to shed light on the kinds of discourse markers used in polit

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Publication Date
Wed Jun 20 2018
Journal Name
Al-academy
Simulation and its applications in contemporary graphic design
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   The simulation is the oldest theory in art, since it appeared in the Greek aesthetic thought of the philosopher Plato, as we find in many of the thinkers and philosophers over a wide period of time to reach our world today. Our fascination with art in general and design art in particular is due to the creativity and innovations of the artist through the simulation, as well as the peculiarities in this simulation, which give objects signs and signals that may have an echo that sometimes does not exist in their physical reality.

   The real representation of life and design construction, descriptions of the expression of each of them in the form of intellectual construction and the ideas of producti

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Publication Date
Thu Jun 01 2006
Journal Name
Journal Of The College Of Languages (jcl)
Demonstratives in English and Arabic : A Contrastive Study
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This paper studies the demonstratives as deictic expressions in Standard Arabic and English by outlining their phonological, syntactic and semantic properties in the two languages. On the basis of the outcome of this outline, a contrastive study of the linguistic properties of this group of deictic expressions in the two languages is conducted next. The aim is to find out what generalizations could be made from the results of this contrastive study.

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Publication Date
Mon Nov 26 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Serum Zinc and Copper Changes in Male Infertility
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Objective: The aim of this study to detect the correlation between trace elements such as zinc, copper and
spermatogenesis, sperm viability and motility.
Methodology: Serum and semen samples were collected from one hundred twenty patients with age ranged (20-
50 years) attending the high institute for Embryo Research and Infertility Treatment/ Baghdad University, in
addition to thirty fertile males their age comparable to that of patients. The period of this study was from June
2004 until the end of October 2004.
Results: The result of routine seminal fluid analysis of all infertile males was divided according to WHO, (1999) limit
into four groups: Asthenospermia(A), Asthenoteratospermia(AT), Oligoasthenoteratospermi

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Publication Date
Sun Jan 01 2012
Journal Name
Biochemistry Research International
Endocytosis and Sphingolipid Scavenging in Leishmania mexicana Amastigotes
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Leishmaniaspecies are the causative agents of the leishmaniases, a spectrum of neglected tropical diseases. Amastigote stage parasites exist within macrophages and scavenge host factors for survival, for example,Leishmaniaspecies utilise host sphingolipid for synthesis of complex sphingolipid. In this studyL. mexicanaendocytosis was shown to be significantly upregulated in amastigotes, indicating that sphingolipid scavenging may be enhanced. However, inhibition of host sphingolipid biosynthesis had no significant effect on amastigote proliferation within a macrophage cell line. In addition, infection itself did not directly influence host biosynthesis.

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