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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
Fri Apr 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The political changes and economic developments in contemporary Turkish Backgrounds, manifestations and future possibilities
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         The research entitled "The political changes and economic developments in contemporary Turkish Backgrounds, manifestations and future possibilities" consists of the introduction, four sections and conclusions. The background details, its developments, and the transformation in the economic   sector in Turkey were reviewed. The first section concentrated on the brief introduction about the political developments which happened since the independence of Turkey at 1923 with the highlight on the years after the receipt of the Freedom and Justice Party (Ak PARTi) the Turkish Government rule. The second section demonstrated the reality of Turkish economy before 2002, while the

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
Places between vanishing and appearing compass and sense in the Iraqi Kurdish poetry translator
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Longer Kurdish poetry translator important tributary of the tributaries of the Iraqi culture contemporary , and a wealth of knowledge rich experiences of an important segment of the Iraqi people , nicked culturally with the languages and cultures of the neighboring nations have , however, much of this potery under depends on the effect of the Arab form and complex , but suffered marginalization and loss as a result of repression by the governments of the country by successive throughout history , and tried to search that offers a vision on the theme of the place and its implications in the Kurdish poetry translator, through the election of a collection of poems and chisels, vertical than that of quantum poetic enormous , but thenature of

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Aljdhiran incision and rip and derivatives in the Qur'an: A statistical study morphological tag
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It is more beneficial science and created and the highest honor is the Koran Sciences, God has honored research in this fun science, came this research that shed the light on the radical incision, and Naughty derivatives as contained in the Koran, and illustrate the diversity of Saghma morphological, and fork them from derivatives what it entailed connotations, as well as the evacuation of cryptic in some of these verses from the biological secrets take minds newly exposed Anitrjt science under the name of scientific miracles.
The research methodology is revenue verse which included the word, and revenue lexical meaning and its meaning in the context of the Qur'an, and reflect the views of the commentators of the verse, and then the r

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Publication Date
Tue Mar 31 2020
Journal Name
College Of Islamic Sciences
The benefits extracted from Surah of Prophet Mohammed ( peace upon him and on his family) from the beginning of Surah until the end of Ayah 15/ the 1st part
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The current study is concerned  over the  benefits  from  our Prophet  ' Surah , these   benefits  are seven  which are : the first : (  The  losing  , disappointment ,  weakness  in the affairs  of those disbelievers ,the second : showing the affairs of the believers   in respect to integrity ,  forgiveness   and rest, the third :  Indicating  the big difference  between the believers and disbelievers , each team has   his own characteristics that being distinguished from the other,  I have explained  the benefit   that the disbelievers are in a difficult

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Ergotamine and its Combination with Vitamin E or Melatonin on Total Antioxidant Status in Migraine Patients
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Free radicals and oxidative damage caused by them have being suggested to be involved in the pathogenesis of migraine. These may result from distorted equilibrium of pro-oxidant/anti-oxidant system that continuously generates and detoxifies oxidants during normal aerobic metabolism. Escape of such system from equilibrium leads to damage of cellular elements with the depletion of cellular stores of anti-oxidants material such as glutathione and vitamin E. Therefore, free radical scavengers (vitamin E or melatonin) seems to be of potential benefit as prophylactic anti-migraine therapy by neutralizing free radicals overproduction and possibly preventing formation of highly toxic intermediates (such as nitric oxide). In addition of being pow

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Publication Date
Sun Jun 07 2009
Journal Name
Baghdad Science Journal
Effect of Saline water and Potash Fertilizer on some chemical constituents in Pisum sativum L.(Var.Senador Cambados) plant.
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Field experiment was conducted to test the effect of saline water and fertilizers rate on Pisum sativum L. plants . Treatments of the experiment included two levels of water salinity (2, 7 dSm-1) as a main plot and three levels of potash fertilization K2SO4 (44%K) namely 150 control, 300 and 450 kg/Donum as a sub plot. Results indicated that irrigation of plant with saline water 7 dSm-¹ caused a significant decrease in K and P contents specially in the upper parts of the plants , the percentage of the K increased (2.80%) under 2 dSm-¹of irrigation water and 300 kg/ donum fertilizer rate in the upper leaves, However K decreased(1.10%) in lower leaves under 7 dSm-¹ and 300 kg/donum fertilizer. while P increased in pods und

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Publication Date
Wed Mar 01 2017
Journal Name
Journal Of Al-nahrain University-science
Cytological Effects of Mutagenic Agents and NaCl on Mitotic Division in Two Iraqi Rice (Oryza sativa L.) Genotypes
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This study was carried out to determine the effects of NaCl (0.00, 50, 100, 150, 180 or 200) mM and two different types of mutagens chemical mutagen ethyl methyl sulphonate (EMS) at 0.5% and physical mutagen UV-B irradiation (40 min time exposure), on mitotic division in two Iraqi rice genotypes Amber 33 (A33) and Amber Baghdad (AB). Different concentrations of NaCl were used. Mitotic index (MI %) was decreased significantly by increasing NaCl concentration, however the highest mitotic index was recorded in mutated genotypes with EMS and UV-B. Different abnormal chromosomes were noticed in mutated plants. Results showed high percentage of abnormal chromosomes in EMS mutated genotypes. In addition no significant differences between genotypes

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Publication Date
Thu Feb 19 2026
Journal Name
Journal Of Physical Education
Consecutive Case Study of Detraining On Some Functional, Physical, Body and Compound Skills Variables In Advance Basketball Players
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Publication Date
Mon Feb 11 2019
Journal Name
Indian Journal Of Animal Research
Effect of energy to protein ratio using alternative feed ingredients on growth performance and nutrient digestibility in broilers
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Present study was conducted to evaluate the different levels of energy to protein ratios (EPR) using food waste and black soldier fly larvae meal (FWBSFL) on growth performance and nutrient digestibility of broilers. A total of 160 one-day old broiler chicks were divided randomly to four groups and each group had 8 replicates with 5 chicks per replicate. The control diet was formulated using conventional feed ingredients with EPR of 154 for the starter period and 167 for the finisher period. The other treatments were diets with normal, low, and high EPR (154,143, and 166 for the starter period; 167, 155, and 177 for the finisher period) using FWBSFL. Feed consumption and body weight gain as well as digestibility of crude protein, cr

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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The role of practices by the Managing of human resources on effectiveness of organizational crisis Management Described and analysis research for ministry of Iraqi interior
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The practice by the  administration of human resources  on effectiveness of organization  crisis as two knowledge fields , it were be until now as center for many studies, but the collect it, study of relation between them ,and The role of practices  by the  administration of human resources  on effectiveness of organization  crisis administration  were considered a new study and first according to the available and showing  studies at this field .

The problem of this research was specified by answer for the question that deal for size of consciousness at the ministry of interior for import of&nbs

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