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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
Sun Oct 07 2012
Journal Name
Journal Of Educational And Psychological Researches
The Effect of KWL Strategy on the Achievement of the Students of the fourth class literary in the subject of History and the Development of Cognitive Thinking skills
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Whereas conventional methods of teaching history do not meet the sometimes purpose has suggested some educators strategies modern help to improve the level of students in the education process through activating prior knowledge and employed in positions of current learning, and focus attention on the points and the outstanding elements of the content and practice techniques Calendar criticof ideas and meanings and mental and linguistic activities used to verify the extent of reaching understanding.                                       &n

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Publication Date
Fri Jan 01 2021
Journal Name
Psychology And Education
The effect of Daniel's model on the development of critical thinking in the subject of Arabic language among students of the College of Management and Economics
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This research aims to identify the impact of Daniel's model on the development of critical thinking. In order to achieve this objective, the following hypotheses are formulated: 1. There is no statistically significant difference at the significance level (0.05) between the average differences in the posttest scores of the experimental group taught according to Daniel's model and the control group taught according to the traditional method in the measure of critical thinking. 2. There is no statistically significant difference at the significance level (0.05) between the average differences in the preand post-tests scores of the experimental group taught according to Daniel's model in the measure of critical thinking. The current research i

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Publication Date
Sat Jan 24 2026
Journal Name
Revista Iberoamericana De Psicología Del Ejercicio Y El Deporte, Issn 1886-8576, Vol. 18, Nº. 3, 2023, Págs. 319-323
The Effect of Using Exercises Associated With Ischemia and Hyperemia on Some Immunoglobulins (Igm - Igg) and White Blood Cells (Wbc) in the Rehabilitation and Treatment of Ankle Sprain Injury Lateral Side of Swimmers
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Autorías: Wafaa Sabah Mohammed Al-Khafaji, Fatimah Hameed Kzar Al-Masoodi, Suadad Ibrahim Suhail Al-Kinani. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 3, 2023. Artículo de Revista en Dialnet.

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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of Sport Science Technology And Physical Activities
The effect of using Daniel's model and Driver’s model in learning a kinetic chain on the uneven bars in the artistic gymnastics for female students
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The aim of this study to identity using Daniel's model and Driver’s model in learning a kinetic chain on the uneven bars in the artistic gymnastics for female students. The researchers used the experimental method to design equivalent groups with a preand post-test, and the research community was identified with the students of the third stage in the college for the academic year 2020-2021 .The subject was, (3) class were randomly selected, so (30) students distributed into (3) groups). has been conducted pretesting after implementation of the curriculum for (4) weeks and used the statistical bag of social sciences(SPSS)to process the results of the research and a set of conclusions was reached, the most important of which is t

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Reinsurance risks and their reflex on the financial performance of the National Insurance Company: Applied Research in Maritime Insurance Branch
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The research dealt with the risks of reinsurance and its impact on the financial performance of the National Insurance Company by focusing on reinsurance in the marine insurance branch. Negative impact on the financial performance of the NICs and the Marine Insurance Branch. The research sample resulted in a main hypothesis that reflects this relationship. Lee in the analysis of financial information reports National Insurance Company of the branch of marine insurance for the period of 2010 until 2017, and the use of (retention) for measuring the re-insurance operations index, and (insurance financial surplus rate) to measure financial performance. For the purpose of obtaining the results, a number of statistical methods were used accord

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Publication Date
Sun Mar 13 2011
Journal Name
Baghdad Science Journal
The Effect of Silybum marianum L. aquatic crude extracts on the cancer cell lines and normal cell line in vitro
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The aquatic crude extract of Silybum marianum dry grains prepared by melting them in distil water by the method of soak and shake. The effect of Silybum marianum crude extract studied in vitro on three tumor cell line the Hep-2, AMN-3 and RD for 24, 48 and 72 hours of exposure, and one cell line of normal cells REF for 72 hr exposure. The results showed that the prescence of toxic effect of the aquatic crude extract on the cell lines of Hep-2, AMN-3 and RD at 10 and 100 µg/ ml upto the higher concentrations when they exposed to the extract for 48 hr. as compared with the control treatment, and when the exposure period increased to 72 hr. the toxic effect started at low concentrations (5 and 10 µg/ ml) as compared with the control g

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Credit Structure Patterns And Their Reflection In The Value Bank Applied Research on a Sample of the Iraqi Private Banks
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The study seeks to determine the levels of credit structure (independent variable) depending on its components (loans, credit disseminate, other facilities) To get the eight patterns of the structure of bank credit for the purpose of assessing the relationship between changes in levels of each style of structure credit (increase or decrease) and reflected in maximizing the value of the Bank(The adopted a measured variable depending on the approximate equation of simple Tobin's Q) to determine the style that achieves the highest value of the Bank, to take advantage of it in management, planning and control by knowing the strengths and weaknesses of the historical distribution of the facilities . the sample of the

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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The strategic recovery of the insurance service and its reflection on achieving the strategic goals: research My application in the National Insurance Company
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The research topic dealt with the strategic recovery of the insurance service, which is one of the approaches that have an important role in providing solutions and remedies for the recession that affects companies and hinders them from achieving their strategic goals. The research also addressed the strategic objectives of the company as the rationale and actual guide for companies of all activities in order to protect their systems from deviation for its desired purpose. So the aim of the research is to demonstrate the repercussions of the strategic recovery of the insurance Service represented by (compensation, speed of response, apology, initiative (identifying the problem). The company's strategic goals are represented (prof

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Publication Date
Sun Jan 01 2023
Journal Name
Dental Hypotheses
Assessment of the Impact of Adhesive and Wires Types on the Tensile Bond Strength of Fixed Lingual Retainers Used in Orthodontics: An In Vitro Study
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Introduction: We aimed to assess the impact of adhesive and wires types on the tensile bond strength of fixed lingual retainers. Methods: A total of 160 intact bovine teeth were collected, cleaned, stored in 25% sodium hypochlorite, and randomly assigned to two groups based on the adhesive type: a two-step adhesive and a one-step adhesive. Each group was further divided into four subgroups based on the type of lingual retainer wire, which included (A) 8-strand braided stainless steel wire, (B) three-strand titanium retainer wire, (C) stainless steel chain, and (D) fiber-reinforced retainer. A tensile bond strength test was conducted using a universal testing machine at a controlled speed of 10 mm/min. Result: The 8-strand braided stainles

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Publication Date
Mon Feb 12 2024
Journal Name
Mustansiriyah Journal Of Sports Science
The impact of the use of numbered head and brainstorming strategies to learn handspring on the Vault table in artistic gymnastics for Men
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The aim of the study was to identify the use of the strategies of numbered heads and brainstorming in learning handspring on the Vault table in artistic gymnastics for Men for the third grade students in the collage of Physical Education and Sport Sciences, as well as to identify the best group among the three research groups (number of heads numbered,, brainstorming strategies And the traditional style group) to learn the skill under study. Using the experimental method, the research subject included the third grade students in the collage of Physical Education and Sports Sciences / University of Baghdad, and randomly by lot, 12 students were selected for each of the three research groups. The study consisted of the arithmetic mean

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