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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 Feb 25 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Investment in higher education and its impact on the labor market: Applied Research in private colleges
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      Investment in high education is considered to be most important factors of production which the return an individual and social than economic returns found by searching the growing problem of unemployment, especially among youth graduates, where the unemployment rate in 2010 (50%) of these high rates have led to increased migration of scientific minds graduate recently, "to search for job opportunities outside Iraq for not hiring functions and this is in vain" clear "in the human and financial resources lead to structural imbalances in the Iraqi economy.  When calculating the correlation coefficient between the graduates and the unemployment rate where it reached (0.21) emerged from the results of

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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
A comparative study of stylistic kriging and Co - kriging Multivariate on the barley crop in Iraq
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Publication Date
Sun Oct 31 2021
Journal Name
Iraqi Geological Journal
Stratigraphy and Nannofossil Biozonation of Sarmord Formation on the Qaywan Anticline in Sulaymaniyah Governorate, Northern Iraq
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The Sarmord Formation is one of the overlooked formations that require more investigations than that achieved before. There are many problems in its definition, age, stratigraphy and aerial distribution. Previously in most parts of the Sulaymaniyah, it is not mapped and its outcrops combined with Balambo Formation while in the present study it is differentiated, mapped in the field on the Qaywan anticline and its problems discussed in details with a suggestion of solutions. For laboratory studies, 31 samples are taken on the Qywan Mountain (anticline) at 23 km north of the Sulaimani city for nannofossils biozonation. This study identified 19 species of the recorded calcareous nannofossils, the studied section reveals three biozones

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Publication Date
Fri Sep 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluating the effect of natural, industrial juices and beverage on orthodontic bonding composite (in-vitro study)
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Publication Date
Wed Jan 01 2020
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The impact of JAK2V617F allelic burden on clinical and laboratory parameters in patients with myeloproliferative neoplasms
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Sun Jun 30 2024
Journal Name
Iraqi Journal Of Science
Study the Effects of Annona sp. Extract on Some Physiological Parameters and Fertility in Diabetic Mice
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     The current study was conducted to investigate Annona fruit pulp effects on the levels of various physiological biomarkers linked with insulin-dependent diabetes mellitus after disease induction in mice, as well as indications of oxidative stress and male hormones. The rats were separated into four groups, three of which were given Alloxan (90 mg/kg body weight) to induce diabetes, while the fourth served as a negative control. The first group of diabetic mice received no therapy, the second received metformin (600 mg/kg body weight) and the third received Annona fruit puree. The mice were sacrificed at the end of the experiment, to acquire blood and tissue samples from the liver, kidneys and spleen. The first untreated gro

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Publication Date
Sun Dec 31 2023
Journal Name
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EFFECT OF PARTICLE SIZE AND DIE HOLES DIAMETER IN THE MACHINE ON BROILER FEED PELLETS QUALITY
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Due to the need for controlling and regulating of feed pellet. Pellet that is imported or locally manufactured is accompanied by cracking and crumbling percentage that occur during transporting and distributing to animals, using conveyors and mechanical feeders. This study aimed to determine the effect of particle size and die holes diameter in the machine on broiler feed pellets quality in pellet durability, pellet direct measurement, pellet expansion, and pellet length. Three particle size 2, 4, and 6 mm, and three diameters of die holes in the machine 3, 4, and 5 mm, have been used. The results showed that changing the particle size from 2 to 4 then to 6 mm led to a significant decrease in pellet durability and pellet lengths, pe

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Publication Date
Wed Aug 30 2023
Journal Name
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Studying the Effect of COVID-19 on Liver Enzymes and Lipid Profile in Iraqi Recovering Patients
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  The Covid-19 virus disease has been shown to affect numerous organs and systems including the liver. The study aimed to compare lipid profiles and liver enzyme levels in individuals who had recovered from Covid-19 infection. To achieve the study objectives, liver Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Alkaline phosphatase (ALP),  Random Blood Sugar (RBS) and Lipid profile which include cholesterol, High-Density Lipoprotein (HDL), Triglycerides (T.G), Low-Density Lipoprotein (LDL), and Very low-density Lipoprotein (VLDL) were determined.

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Publication Date
Thu Mar 01 2012
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Histopathological Studies of the Liver and Kidney in Mice Fed on Smut Wheat Infected with Tilletia
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The current study was designed to investigate the effect of Tilletia smut spores on histopathological changes in liver and kidney in mice. Twenty animals were divided into two equal groups, 10 mice each, control group fed on normal diet and the treated groups were fed on a mixture of 50% normal diet with 50% wheat infected with Tilletia for 30 days. Histopathological sections taken from liver and kidney treated with Tilletia revealed several alterations. The changes in liver included, multiple granulomatous lesions, area of coagulation necrosis, vacuolar degeneration in the cytoplasm of hepatocytes, proliferation of hepatocytes with formation of pseudolobull which initiates for procancer. Whereas in the kidney, the changes included

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Leadership Skills and their Impact on Strategic Planning: Applied Research in the Iraqi Ministry of Planning
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