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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
Wed Oct 02 2024
Journal Name
International Development Planning Review
A COMPARATIVE STUDY OF THE AMOUNT OF FORCE EXERTED ON THE GROUND AND THE TIME OF PROPULSION IN THE VERTICAL AND HORIZONTAL JUMPING TESTS FROM STABILITY USING A FOOT SCAN DEVICE
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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The risks of derivatives contracts and their reflections on the global financial crisis Analytical study in (Toronto – Dominion) bank
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The research tacklets the role of risks arising from the excessive use of derivative contracts for trading in financial crises, including the recent global financial crisis in (2008) which is known the mortgage crisis.

   In order to prove the hypothesis of the research, the risk index of derivative contracts has been chosed as expressed in the measure of (value at risk) to be the main field for testing the hypothesis of research. The duration of the contract  has been also chased  for (15) years between the years (2001- 2015), the period preceding the global financial crisis, while the second represents the period of time that followed. The research reached a number of conclusions, bu

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Publication Date
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effects of Melatonin On The Oxidative Stress , Protein Glycation , Microalbuminuria and Lipid Profile In Type II Diabetes Mellitus
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Previous studies indicated that supplementation with antioxidants has a protective effects against oxidative stress–induced damage in type 2 diabetes. In this study we evaluated the antioxidant effects of melatonin on the oxidative stress parameters and microalbuminuria in type 2 DM patients. 30 patients with type 2 DM were treated with 3mg/day melatonin for 90 days. Erythrocytes and plasma MDA and glutathione, fasting plasma glucose, %HbAIC, microalbuminuria, total plasma protein and lipid profile were measured each 30 days and compared with those obtained from 20 healthy controls.

A decrease in MDA levels associated with the elevation in GSH levels were observed, compared with the pre–treatment levels.

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Publication Date
Sun Dec 06 2009
Journal Name
Baghdad Science Journal
THE EFFECT OF RAMADI SEWAGE TREATMENT PLANT ON THE PHYTOPLANKTON AND SOME PHYSICO – CHEMICAL CHARACTERS IN EUPHRATES RIVER , IRAQ
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Four localities were selected in Euphrates River and Ramadi sewage treatment plant to collect water samples monthly during the period between October 2001 to July 2002 . Total cell count of phytoplankton and its physico- chemical concentrations were determined . The study aimed to demonstrate the effect of Ramadi sewage treatment plant on Euhprates River . It is concluded that the sewage had an dilution effect for the total hardness , total alkalinity , electrical conductivity and salinity of Euphrates River , but it is also caused in the presence of a contaminated area . This was cleared from the depletion of dissolved oxygen and high values of biological oxygen demand with lower valuse of pH in this area . The water of Euphrates

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Publication Date
Tue Mar 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
Employing the indicators of stereotypes and the dimensions of organizational clarity and their role in achieving the planned organizational behavior Analytical study on a sample of workers in some departments of the Faculties of Engineering, University of
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The current research examines the employment of indicators of stereotypes and the dimensions of organizational clarification to achieve planned organizational behaviour on a sample of employees in a number of departments of the Faculties of Engineering, University of Kufa, for a sample of (122) teaching staff. This research proposes the use of positive indicators of stereotypes for both the organization and employees and their awareness of what they want to obtain and what should be done for both parties and the removal of organizational clarity represented by the functional dimension that explores to what degree the employee's understanding of the internal strategy of the organization and the strategic dimension that searches fo

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Publication Date
Sun Sep 30 2012
Journal Name
College Of Islamic Sciences
Abolition and suspension in the verbs of the novice and the news
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In the Name of God, the Most Gracious, the Most Merciful
     Praise be to God, who taught the pen anthropology unless he knows, and peace and blessings be upon the master of bullying, and the imam of the eloquent Prophet Muhammad, the sincere and faithful, and his family and companions as a whole and whoever followed him to the Day of Judgment. And after:
       The science of grammar is among the most important of all language sciences at all, if not the most important of its sciences, due to the multiplicity of its doctrines and schools, the diversity of its methods, its phenomena and subjects, as well as the connection of this science with the most honorable languages,

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of Clinical And Experimental Dentistry
Resistance of bonded premolars to four artificial ageing models post enamel conditioning with a novel calcium-phosphate paste
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Background: This in vitro study compares a novel calcium-phosphate etchant paste to conventional 37% phosphoric acid gel for bonding metal and ceramic brackets by evaluating the shear bond strength, remnant adhesive and enamel damage following water storage, acid challenge and fatigue loading. Material and Methods: Metal and ceramic brackets were bonded to 240 extracted human premolars using two enamel conditioning protocols: conventional 37% phosphoric acid (PA) gel (control), and an acidic calcium-phosphate (CaP) paste. The CaP paste was prepared from β-tricalcium phosphate and monocalcium phosphate monohydrate powders mixed with 37% phosphoric acid solution, and the resulting phase was confirmed using FTIR. The bonded premolars were exp

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Publication Date
Wed Jun 01 2022
Journal Name
Civil Engineering Journal
Usage of EB-CFRP for Improved Flexural Capacity of Unbonded Post-Tensioned Concrete Members Exposed to Partially Damaged Strands
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The study presents the performance of flexural strengthening of concrete members exposed to partially unbonded prestressing with a particular emphasis on the amount (0, 14.2, and 28.5%) of cut strands-symmetrical and asymmetrical damage. In addition to examining the influence of cut strands on the remaining capacity of post-tensioned unbonded members and the effectiveness of carbon fiber reinforced polymer laminates restoration, The investigated results on rectangular members subjected to a four-point static bending load based on the composition of the laminate affected the stress of the CFRP, the failure mode, and flexural strength and deflection are covered in this study. The experimental results revealed that the usage of CFRP la

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Publication Date
Fri Jan 23 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of in office bleaching on surface roughness and micro-hardness of newly developed composite materials (In vitro study)
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Background: Alterations in the microhardness and roughness are commonly used to analyze the possible negative effects of bleaching products on restorative materials. This in vitro study evaluated the effect of in-office bleaching (SDI pola office +) on the surface roughness and micro-hardness of four newly developed composite materials (Z350XT –nano-filled, Z250XT-nano-hybrid, Z250-mico-hybrid and Silorane-silorane based). Materials and methods: Eighty circular samples with A3 shading were prepared by using Teflon mold 2mm thickness and 10mm in diameter. 20 samples for each material, 10 samples for base line measurement (surface roughness by using portable profillometer, and micro-hardness by usingDigital Micro Vickers Hardness Test

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Publication Date
Wed Mar 28 2018
Journal Name
Indian Journal Of Natural Sciences
Detection of the Main Mycotoxins in Feed of Horses in Al-Zawra'a Park and Study their Effects on Hematological Feature
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