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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 Jan 01 2020
Journal Name
Dental Research Journal
Impact of a mixture of nanofiller and intrinsic pigment on tear strength and hardness of two types of maxillofacial silicone elastomers
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Background: The ideal maxillofacial prosthesis should have fine and thin boundaries that bindwith the surrounding facial structures and possess high tear strength.This study aims to determinethe best percentages of nanofiller (TiO2) and intrinsic pigment (silicone functional intrinsic) thatcould be mixed in as additives to improve the tear strength of Cosmesil M511 andVST50F siliconeelastomers with the least effect on their hardness.Materials and Methods: In this in vitro experimental study, a total of 80 samples, 40 for eachelastomer, were fabricated. Each elastomer sample was split into two equal groups to test for tearstrength and Shore A hardness. Each group consisted of 20 samples, including 10 control sampleswithout additives and 10 e

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Publication Date
Thu Jan 02 2020
Journal Name
Journal Of The College Of Languages (jcl)
The composition of the vocabulary and passages in the poems of Saadi: بررسی ترکیب‌ سازی در قصاید و قطعات سعدی
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The importance of research and study of classical Persian literature is not overlooked.  So far, there have been many studies in this area.  But there are still some things that need more research.  Persian grammar is one of the most important branches of Persian literature.  This section has always been converted at different times.  One of the issues that has been neglected in the studies of classical literature is the study of the technical tales of past and past poetry.  These texts can be studied from different perspectives.  Because Persian is a mixed language, it is possible to combine language terms with each other or to add prefixes and suffixes to express new concepts. They can be used by exam

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Publication Date
Wed Feb 25 2026
Journal Name
Journal Of Language Studies
Opening the Box of Suffering, Unleashing the Evils of the World’: Pandora and her Representation in Nineteenth-Century American Poetry
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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The mediator role of the psychological contract in light of the linking between training needs and organizational commitment - exploratory search
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  The purpose of this research shed light on the analysis of the relationship between training needs and organizational commitment and the role of a variable contract psychological, and start search of a dilemma thought provoking fundamental questions revolve around the search was the answer to all those questions of tricks theoretical framework to the variables of research first and test models of the relationship and impact secondly During six hypotheses major, The objective of the research the impact of the factors that affect training needs in organizational commitment center the psychological contract, and applied research on a sample of 100 individuals working in the engineering department and maintenance at the D

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Publication Date
Thu Jan 02 2020
Journal Name
Journal Of The College Of Languages (jcl)
The personality of the woman and her role in the products of Agnon: דמותה ותפקידה של האישה ביצירותיו של עגנון
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  Shmuel Yosef Agnon, a well-known Jewish writer, wrote many literary works, including poetry, story, etc. In the field of story, this writer used two areas: the first: a simple exterior, and the second: an inner full of secrets and mysteries. This area is common when Agnon is affected by his symbolic method of purpose. In his productions, we find the political and historical significance embodied in his characters, where there is almost no story without it.

    Agnon and all his productions gave the character a large area, Agnon’s characters often play the center and cornerstone in those productions, where the author dealt deeply and stated the fines details of the external and internal of that ch

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Publication Date
Fri May 01 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
The Psychological Pollution And Its Role In The Effectiveness Of The Administrative Performance Of International Stadiums Staff (Baghdad, Arbil, Basrah)
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Publication Date
Sun May 15 2022
Journal Name
Bionatura
Comparison between the presence and absence of mixing in the anaerobic biological treatment of liquid waste for the cheese industry
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Many nations are seeing an increase in water pollution from dairy and cheese production due to the high organic and fat content in their waste products and the high temperature of their waste products, which elevates the water temperature and causes loss to ecosystem components. Reusing industrial wastewater that has been treated to guarantee no harm has been done to the environment is being hampered by a lack of water. This study compares the presence and absence of mixing in the anaerobic biological treatment of liquid waste for the cheese industry. To decrease heat exchange with the external environment, cube-shaped anaerobic reactors with dimensions of (30 x 30 x 30) cm and thick glass (10 mm) were utilized in this investigation

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Publication Date
Wed Feb 25 2026
Journal Name
Journal Of The College Of Basic Education
The impact of cross-training in the development of the skills of the crushing blow and the blow-to-blow stroke under the age of 17
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Publication Date
Sat Sep 30 2023
Journal Name
مجلة نسق
The American position on political developments in Turkey 1945-1960
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After word war ll, the United States of America pursued a policy of containment aimed at preventing the Soviet Union from penetrating into the countries of the world, especially the regions of the Middle East, Therefore, it worked to emphasize the establishment of relations that include various political, economic and even cultural aspects, and focused its policy in his aspect on Turkey due to its geopolitical position. At a time when Turkey was undergoing developments at various levels and a change in govemment policy after the Demccratic Party came to power, which focused in its foreign policy on strengthening reltions with the West in general and the United States America in particular. The US government was the supporter of Democrat

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Publication Date
Sat Sep 01 2018
Journal Name
Indonesian Journal Of Electrical Engineering And Computer Science
The Factors Affecting on Managing Sensitive Data in Cloud Computing
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Cloud computing represents the most important shift in computing and information technology (IT). However, security and privacy remain the main obstacles to its widespread adoption. In this research we will review the security and privacy challenges that affect critical data in cloud computing and identify solutions that are used to address these challenges. Some questions that need answers are: (a) User access management, (b) Protect privacy of sensitive data, (c) Identity anonymity to protect the Identity of user and data file. To answer these questions, a systematic literature review was conducted and structured interview with several security experts working on cloud computing security to investigate the main objectives of propo

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