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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 Sep 01 2021
Journal Name
Iraqi Journal Of Physics
Theoretical Calculations of the Cross-sections for (n,α) and (n,xα) reactions on the Structural Material for Fusion Reactor 46-50Ti
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The biggest problem of structural materials for fusion reactor is the damage caused by the fusion product neutrons to the structural material. If this problem is overcomed, an important milestone will be left behind in fusion energy. One of the important problems of the structural material is that nuclei forming the structural material interacting with fusion neutrons are transmuted to stable or radioactive nuclei via (n, x) (x; alpha, proton, gamma etc.) reactions. In particular, the concentration of helium gas in the structural material increases through deuteron- tritium (D-T) and (n, α) reactions, and this increase significantly changes the microstructure and the properties of the structural materials. T

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Publication Date
Wed Mar 16 2011
Journal Name
Alustath
The Search for Power in C. P. Snow The Light and the Dark
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The Light and the Dark is the fourth novel in a series written by Charles Percy Snow where it tackles a phase of gifted scholar and remarkable individual Roy Calvert as he search for a source of power and meaning in life to relieve his inner turmoil. The character Roy Calvert is based on Snow's friend, Charles Allbery who exposes the message the character of Roy intends to convey in a certain phase of his life and the prophecy the novel carries amid catastrophe so widespread in the thirties of the twentieth century

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Publication Date
Mon Sep 03 2018
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Al-academy
Integrative Relationship between the Picture and the Written Text in the Commercial Advertisement
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There is no doubt that the   advertisement picture  and the written text play  a key role in the formation of the language of the communicative discourse as the main pillars of the design of commercial advertising and the main entrance for the  advertising message awareness... Hence the researcher chose the title of her research (Integrative Relationship between the Picture and the Written Text in the Printed Commercial Advertisement) starting from following questions: What is the relationship between the picture and the written text in the printed commercial declaration? Is there functional, aesthetic and interactive integration between them?

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Publication Date
Tue May 12 2009
Journal Name
World Environmental And Water Resources Congress 2009
Modeling the Evolution of Incised Streams in Hammar Mesopotomian Marsh with Emphasis on the Contribution of Tidal Flow in the Filling Requirements
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Publication Date
Thu Feb 19 2026
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Al–bahith Al–a'alami
The strategy of Marketable Public Relations Internationally Analytical study of the websites of “ Apple “ and “Samsung “ on the internet: (A research drawn from a Master Degree thesis)
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The international organizations showed their interest in the marketable public relations, with their activities, means and strategies, they play a crucial role in marketing products, services and ideas of the institution. They are considered to be the link between the company and its public, They are responsible for presenting the institution to the public, with honest transmission of the information. This gives a good impression to the institution, in a way the institution and its products become consistent with the needs and interests of the public.  Based on this, the research aims to identify the strategies used by the marketable public relations internationally.  The r

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Publication Date
Sat Jun 04 2022
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Motives for public exposure to specialized sports satellite channels and the gratifications achieved from it: A survey study on the public of the city of Baghdad
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Motives for public exposure to specialized sports satellite channels and the gratifications achieved about it - Research presented by (Dr. Dr. Laila Ali Jumaa), Imam Al-Kadhim College (peace be upon him) - Department of Information-2021.

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Tue May 28 2024
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Publication Date
Sun Sep 27 2020
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John Tyler and his Role in the America Domestic and Foreign Policy (1841-1845)
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The current paper highlights an important character represented by the American president John Tyler 1841 – 1845, who is considered the tenth American president. The importance of this paper lies in identifying his personality in terms of his upbringing and the political activities he practiced before assuming the presidency and his most significant internal achievements, which showed his decisions as a president. He was fully prepared to support national policies since they do not exceed the authorities of the states. With his achievements in the foreign policy, he was capable to draw and define the features of the American foreign relations that were in harmony with the general situation in the United States of America at that time.

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Publication Date
Wed Jan 01 2020
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The Arithmetic Coding and Hybrid Discrete Wavelet and Cosine Transform Approaches in Image Compression
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Image compression is one of the data compression types applied to digital images in order to reduce their high cost for storage and/or transmission. Image compression algorithms may take the benefit of visual sensitivity and statistical properties of image data to deliver superior results in comparison with generic data compression schemes, which are used for other digital data. In the first approach, the input image is divided into blocks, each of which is 16 x 16, 32 x 32, or 64 x 64 pixels. The blocks are converted first into a string; then, encoded by using a lossless and dictionary-based algorithm known as arithmetic coding. The more occurrence of the pixels values is codded in few bits compare with pixel values of less occurre

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Wed May 18 2016
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