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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
Tue Dec 13 2011
Journal Name
Iraqi Journal Of Laser
The Effect of 532nm Nd: YAG Pulsed Laser on the Activity of Superoxide dismutase and Alcoholdehydrogenase of Saccharomyces Cerevisiae
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In this study, the effect of Nd: YAG laser on the activity of superoxide dismutase (SOD) and alcoholdehydrogenase (ADH) was investigated. The Saccharomyces cells were irradiated using 532nm Q-Switched Nd: YAG laser with (1Hz) frequency. Different fluences 11.3, 22.6 and 33.9mJ/cm2 and different number of pulses 15, 30 and 60 pulse were used. The irradiated cells were incubated in a liquid nutritive medium for 24 hours. After incubation, the cells were harvested and disrupted to extract the intracellular enzymes and their activities were assessed. In comparison with the control, the irradiated cells showed a significant increase in the activity and the specific activity of SOD at energy densities of 11.3 and 22.6mJ/cm2 at 30 and 60 pulses

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Publication Date
Mon Jul 24 2023
Journal Name
Pollution Research
THERMODYNAMIC AND KINETIC STUDY OF ADSORPTION OF THE AZO DYE FROM AQUEOUS SOLUTION ON THE SURFACE OF IRAQI FLINT
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Publication Date
Tue Feb 03 2026
Journal Name
Journal Of Physical Education
The Effect Of Psychological Counselling On The Development Of Psychological Skills and the Level Of First Class Soccer Referees (Baghdad governorate)
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Publication Date
Fri Jan 22 2021
Journal Name
International Journal Of Agricultural & Statistical Sciences
EFFECT OF GROWING MEDIA, NUTRIENT SOLUTION AND CONTROL OF FLOWERING ON THE PRODUCTIVITY OF THE CUCUMBER CULTIVATED BY THE SOILLESS CULTURE.
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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of Insertion Rate on The Adaptability of Gutta-Percha and The Apical Extrusion of Thermoplasticized Gutta Percha Obturation Techniques.
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Background: In the Thermafil as a root canal obturation, system little is known about the effect that varying rates of insertion have on the adaptability of thermoplasticized GP and the amount of apical extrusion. Materials and methods: thirty simulated root canals were obturated with thermafil obturators and Apexit Plus sealer at three different insertion rates. The obturated canals were sectioned at three different levels, the sealer average film thickness for each section was calculated and the amount of apical extrusion for each canal was conducted. Results: the higher adaptability was seen with the faster insertion rate while the slower insertion rate showed fewer tendencies to cause apical extrusion. Conclusions: the intermediate i

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Physics: Conference Series
Measurement the Concentrations of Radon and Thoron and Their Progeny in the Air Samples of Al-Haswaa City in Babylon province
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Publication Date
Sun May 10 2015
Journal Name
Al-academy
The system and Disorder of shape and content in Interior Design Educational halls in the Ministry of Labor and Social Affairs (Analytical study): رجاء سعدي لفتة
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Dealing with this study to find a link principle in the construction of the system and disorder to the promise of the principles and concepts of intellectual and philosophical form and content in the act of interior design of the halls education in the Ministry of Labor and Social Affairs , which leads to a reaction design objective and functionally and to increase the strength of the effect on users of the coaches and trainers . As it informs the side cognitive and developmental study of the design of the interior spaces . So it was the goal of research in the detection of the nature of the system and disorder with Focus indicators and the type of regulations and privacy and what constitutes the framework of knowledge in order to explai

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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of exercising occupational hypocrisy on organizational strategic success: An Empirical study on university of kufa faculty of administration and economic
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This research aims to identify the relationship between occupational hypocrisy and organizational strategic success, It was done by analyzing the correlations and influence between variables,  applied to a random sample of university professors at the University of Kufa faculty of administration and economic.

 The main tool for data collection is the survey were questionnaires were distributed randomly to the professors , and (43) questionnaires were returned, and test its validity by using (SEM) (Structural Equation Modeling), Hypothesis has been tested by using Statistical Package for Social Sciences (SPSS v. 18), The research found a set of conclusions:(The occupational hypocrisy has

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Publication Date
Tue Jun 02 2020
Journal Name
Diyala Journal Of Medicine
Histological and Immunohistochemical Study of Osteocalcin to Evaluate The Effect of Local Application of Symphytum Officinale Oil on Bone Healing on Rat
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Background: The repair of bone defects remains a major clinical challenge in dentistry. Bone is a highly vascularized tissue reliant on the close spatial and temporal connection between blood vessels and bone cells to maintain skeletal integrity. The health promotive , preventive, and curative properties of herbs were recognized by the ancient and the present pharmacist and physicians to form the theoretical foundations in Medicine. Objective: Immunohistochemistry of osteocalcin and histological study to prove that symphytum officinale oil when applied locally on generated bone defect healing in rat tibia, it was very effectiveness. Patients and Methods: 0ur study fourty male rats , weighting (250-350) grams ,aged (5 7)months ,was

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Publication Date
Wed Jan 01 2020
Journal Name
Biochemical Of Cellular Archieves
HISTOLOGICAL AND IMMUNOHISTOCHEMICAL STUDY OF OSTEOCALCIN TO EVALUATION THE EFFECT OF LOCAL APPLICATION OF LEPIDIUM SATIVUM OIL ON BONE HEALING ON RAT
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ABSTRACT : The restoration of bone continuity and bone union are complex processes and their success is determined by the effectiveness of osteosynthesis. The use of plants for healing purposes predates human history and forms the source of current modern medicine. This research was planned to study the histological and immunohisto-chemistry of osteocalcin to evaluate of effect of local application of lepidium sativum oilon healing of induced bone defect in rat tibia. In this study, fourty albino male rats, weighting (300-400) gram, aged (6-8) months, will be used under control conditions of temperature, drinking and food consumption. The animals will subject for a surgical operation of medial side of tibiae bone, in control group the bone

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