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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 Dec 19 2019
Journal Name
مجلة العلوم النفسية
Employment of the Roundhouse Strategy and its Impact on Academic Achievement and Core Thinking
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The aim of this research is to employ the roundhouse strategy to study its impact on the students achievement of the 10th grade in physics and their core thinking. After the application of the research experience and gaining data, which was processed statistically using the statistical packages program (SPSS). The results of the researcher revealed the superiority of the students of the experimental group who studied using the roundhouse strategy on the students of the control group who studied the usual method in the achievement test. As results showed that there were statistically significant differences between the average scores of the experimental group and the average scores of the control group students in the core thinking test and

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Publication Date
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
Illiteracy and its Impact on the Reality of Iraqi Youth between Heritage and Contemporary
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Illiteracy has spread in the last years, although it was eliminated in the 1980s. The return of illiteracy brings ignorance, illness, backwardness and regression among nations. It has taken many types, mainly alphabetical, scientific and computer illiteracy. Hence, the increasing nature of illiteracy has attracted the attention of governments and societies alike. This may touch the reality of societies starting with their youth unless those, who are in charge, will find workable solutions for the existing problems. The results of the study revealed that there is a real disaster awaiting the next generation after years of stray, and ignorance of the people in charge who are too engaged in getting their privileges to care about this proble

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Publication Date
Tue Jul 14 2015
Journal Name
Ibn Al-haitham J. For Pure & Appl. Sci.
Effect of Annealing Temperature and Thickness on the Structural and Optical Properties of CdSeThin Films
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CdSe alloy has been prepared successfully from its high purity elements. Thin films of this alloy with different thicknesses (300,700)nm have been grown on glass substrates at room temperature under very low pressure (10-5)Torr with rate of deposition (1.7)nm/sec by thermal evaporation technique, after that these thin films have been heat treated under low pressure (10-2)Torr at (473,673)K for one hour. X-ray patterns showed that both CdSe alloy and thin films are polycrystalline and have the hexagonal structure with preferential orientation in the [100] and [002] direction respectively. The optical measurements indicated that CdSe thin films have allowed direct optical energy band gap, and it increases from (1.77- 1.84) eV and from

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Publication Date
Wed May 14 2025
Journal Name
Journal Of Applied Mathematics
Role of Wind and Fear on the Dynamic of a Prey and Two Competing Predators
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An essential tool for studying the web is its ability to show how energy moves through an ecosystem. Understanding and elucidating the relationship between species variety and their placement within the inclusive trophic dynamics is also beneficial. A food web ecological model with prey and two rival predators under fear and wind flow conditions is developed in this article. The boundedness and positivity of the system’s solution are established mathematically. The stability and existence constraints of the system’s equilibria are examined. The proposed system’s persistence limitations are established. Additionally, the bifurcation analysis of every potential equilibrium is examined using the Sotomayor theorem. To describe the

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
Administrative coordination between the Federal Ministry and the local government and its impact on municipal performance An applied study in the municipalities of Dhi Qar Governorate
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       The aim of the research is to show the extent of the impact of administrative coordination on municipal performance after the state’s tendency to implement administrative decentralization and transfer of powers (administrative, legal, financial, and technical) from the Federal Ministry (construction, housing, municipalities, and public works) to local governments (governorates), to meet local needs, And since the municipality is considered one of the local administrative institutions and most of its goal is to provide increased municipal services to citizens due to population growth and urban expansion of cities by coordinating their actions using their powers, and in order to address gaps i

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Crossref
Publication Date
Thu Jan 22 2026
Journal Name
Opción: Revista De Ciencias Humanas Y Sociales, Issn 1012-1587, Nº. Extra 21, 2019, Págs. 907-927
The Effect Of The Perkins’ And Blythe’s Model On Mathematical Communication Among Students Of The 5Th Bio Scientific Grade In Mathematics
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Autorías: Muayad Kadhim Raheem, Lina Fouad Jawad. Localización: Opción: Revista de Ciencias Humanas y Sociales. Nº. 21, 2019. Artículo de Revista en Dialnet.

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Publication Date
Mon May 19 2025
Journal Name
Retos
The effect of the cube model on visual-spatial intelligence and learning the skill of spiking in volleyball for female students
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Objective: To identify the effect of the cube model on visual-spatial intelligence and learning the skill of spikinging in volleyball for female students, The researchers used the experimental method by designing two equivalent groups with pre- and post-measurements. Research methodology: The main research sample of (30) female students was selected from the research community represented by second-stage students in the College of Physical Education and Sports Sciences - University of Baghdad for the academic year (2024-2025). The sample was divided equally into two control and experimental groups. The researchers conducted the sample homogenization process and the equivalence process between the two groups in the variables of visua

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Publication Date
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
The Effect of Continuous Darkness and Continuous Light on the Reactivity of Smooth Muscles to Drugs in the Rat Vas Deferens
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Background: The vasoconstricting agents: nor-adrenaline and 5- hydroxytryptamine
(5-HT) have a stimulant action on smooth muscle contractility of the rat vas deferens.
Objective: This study aimed to investigate the effect of exposure to continuous
darkness and continuous light on the contractility of the vasa deferntia smooth
muscles from rats to applied nor-adrenaline and 5-HT.
Method: Male albino wistar rats were divided into 3 experimental groups. Group 1:
Control animals, were exposed to the ordinary photoperiod each day. Group 2: Rats
were kept in a dark room. Group 3: In a room under a bright artificial light.
All animals were killed after 4 weeks.
Results: Vasa deferentia preparations from continuous dar

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Publication Date
Thu Dec 15 2022
Journal Name
Journal Of Juridical And Political Science
Civil Liability Arising from Children Abuse. A Comparative Study of American Law
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Researchers are interested in the issue of children abuse and they look for its cause in the past and present. Their interest is limited to identifying penal liability which is caused by children abuse away from focusing on civil liability. So, the study is going to clarify the parents' responsibility for children abuse rather than civil liability of the medic in case he wouldn’t notify the authorities about the case according to the American law rules and the attitude of Iraqi law rather than some judicial application of civil cases that were exposed to American judiciary concerning children abuse.

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Crossref
Publication Date
Thu Dec 15 2022
Journal Name
Journal Of Juridical And Political Science
Civil Liability Arising from Children Abuse. A Comparative Study of American Law
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Researchers are interested in the issue of children abuse and they look for its cause in the past and present. Their interest is limited to identifying penal liability which is caused by children abuse away from focusing on civil liability. So, the study is going to clarify the parents' responsibility for children abuse rather than civil liability of the medic in case he wouldn’t notify the authorities about the case according to the American law rules and the attitude of Iraqi law rather than some judicial application of civil cases that were exposed to American judiciary concerning children abuse.

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