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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 Jan 01 2019
Journal Name
International Journal Of Supply Chain Management
The effect of internal training and auditing of auditors on supply chain management: An empirical study in listed companies of Iraqi stock exchange for the period 2012-2015
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Publication Date
Sat May 07 2022
Journal Name
American Journal Of Economics And Business Management
The Integrating Effect Resource Consumption Accounting (RCA) and Enterprise Resource Planning (ERP) On Cost Reduction and Quality Improvement
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The research aims to examine the integration effect among resource consumption accounting (RCA) system and the enterprise resource planning (ERP) on both costs reduction and quality improvement. The study questioner form distributed to two different respondents as the unit of analysis. The research reached various conclusions most important of which is the integration relationship can help solve the special difficulties in managing the economic unit data. Moreover, the integration provides a clear picture of the causal relationships between resources, resource quantities, and associated costs

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Publication Date
Sat Sep 30 2017
Journal Name
College Of Islamic Sciences
Women and Symbol In the stories of Mowaffaq Khadr
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The world of Muwaffaq Khidr Al-Qasasi has a clear and realistic orientation. This trend is in full harmony with his philosophy and vision of life and things. Through self-awareness is nothing but an expression of an imbalance in the interaction between self and reality, and it remains lacking in credibility.

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Morphological Participation in the Forms of (Faul) and (Fael)
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This research examines the phenomenon of the Arabic language repeated in the Qur'an and poetry, as some morphological formulas are valid in their uses and indications in more than one way. search).

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Publication Date
Sun Jan 27 2019
Journal Name
Journal Of The College Of Education For Women
Jews and their role in the heritage of Baghdadi
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The research sheds light on an important religious sect that played a fundamental role in the structure of the Iraqi society in general and the Baghdadi society in particular, in which the Jews in general and the Jewish women in particular played an active role in the culture and heritage of Baghdadi society. The educational, cultural and artistic activity of Jewish literacy is a model for study.

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Publication Date
Sun Dec 10 2017
Journal Name
Al-academy
Form and function in the design of intellectual toys
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Playing is the only common language among children in every place and time, to the fact that what distinguishes the children is their quest to play and fun way innate, not acquired, which is expressed with the child really is one of the rights. And play a key entrance to the growth of the child mentally, intellectually and cognitively and not for the child emotionally and socially just. In the play the child begins to identify and classify objects and learn concepts and circulate among themselves on a linguistic basis. Activity here and play a major role in leading the linguistic development of the child in the composition has the communication skills.

The Games (especially intellectual ones) Whatever the cause of the development

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Publication Date
Fri Dec 15 2023
Journal Name
Al-academy
The dialectic of form and meaning in postmodern art
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Some have considered the dialectic in form and meaning from different points of view, and dismantled them from each other, and this view is correct if we adopt according to the logic of Aristotle when it comes to dialectic, the dialectic of form and meaning has different aspects and does not share a single line in terms of conceptual meaning, the form is the appearance What the recipient sees with the help of cognitive tools, the content or content is the mental meaning, which in turn depends on his own tools, and to this extent this view is correct, and the intellectual content or meaning of the artwork or the human message that the artist wants to convey to the viewer.
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Publication Date
Mon Mar 02 2015
Journal Name
Chemistry And Materials Research
Synthesis and Characterization of 3,5-Dimethyl-2- (4-nitrophenyl azo)-PhenolComplexes with Co(II) and Ni(II) and Study Its Effect on the Activity of AchEnzyme(invitro)
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Transition metal complexes of Co(II) and Ni(II) with azo dye 3,5-dimethyl-2-(4-nitrophenylazo)-phenol derived from 4-nitoaniline and3,5-dimethylphenol were synthesized. Characterization of these compounds has been done on the basis of elemental analysis,electronic data, FT-IR,UV-Vis and 1 HNMR, as well as magnetic susceptibility and conductivity measurements. The nature of thecomplexes formed were studies following the mole ratio and continuous variation methods, Beer ' s law obeyed over a concentrationrange (1x10 -4 - 3x10 -4 M). High molar absorbtivity of the complex solutions were observed. From the analytical data, thestoichiomerty of the complexes has been found to be 1:2 (Metal:ligand). On the basis of physicochemical data tetrahedral

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Publication Date
Sun Jul 01 2012
Journal Name
American Journal Of Veterinary Research
Effect of brachycephalic, mesaticephalic, and dolichocephalic head conformations on olfactory bulb angle and orientation in dogs as determined by use of in vivo magnetic resonance imaging
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Abstract<p><bold>Objective</bold>—To determine the effect of head conformation (brachycephalic, mesaticephalic, and dolichocephalic) on olfactory bulb angle and orientation in dogs by use of in vivo MRI.</p><p><bold>Animals</bold>—40 client-owned dogs undergoing MRI for diagnosis of conditions that did not affect skull conformation or olfactory bulb anatomy.</p><p><bold>Procedures</bold>—For each dog, 2 head conformation indices were calculated. Olfactory bulb angle and an index of olfactory bulb orientation relative to the rest of the CNS were determined by use of measurements obtained from sagittal T2-weighted MRI images.</p><p><bold>R</bold></p> ... Show More
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Publication Date
Wed Jun 15 2022
Journal Name
Journal Of Baghdad College Of Dentistry
Effects of various analgesics on pain perception and rate of tooth movement: a randomized controlled clinical study
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Background: Pain is one of the most reported side effects of orthodontic treatment despite the advanced technology in orthodontics. Many analgesics have been introduced to control orthodontic pain including acetaminophen and selective and nonselective nonsteroidal anti-inflammatory drugs. The great concern about these drugs is their adverse effect on rate of teeth movement. Aims: The purpose of this study was to evaluate and compare the effect of acetaminophen, ibuprofen and etoricoxib on pain perception and their influence on the rate of teeth movement during leveling and alignment stage. Methods: Forty patients were evenly and randomly distributed in a blinded way to one of four groups: placebo (starch capsules), acetaminophen 500mg th

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