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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
Thu Jun 02 2016
Journal Name
مجلة العلوم التربوية والنفسية
The effect of the K.W.L.Plus strategy in developing the mental skills and reflective thinking of first-year middle school female students
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Publication Date
Sun Mar 13 2011
Journal Name
Baghdad Science Journal
Testing the efficiency of duckweed Lemna spp. in reducing the concentration of zinc and iron from the wastewater when increase biomass
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The study searches for the possibility of using duckweed Lemna spp. to reduce the concentration of heavy metals (zinc and iron) in the wastewater of Baghdad by culturing two different densities of the plant with a fresh weights 5 and 10 g/l and without the plant under optimum uncontrolled conditions. The result showed that there was a significant differences at the possibility level of (p? 0.05) for the three treatments, as the highest percentages for zinc removal in the second day for the plant treatment of 5 g/l were 66.40%, while the highest percentage of iron removal were in the tenth days for the plant treatment 10 g/l were 80 %, and noticed that the increase of the heavy metals concentrations accumulated in the plant after bei

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Educational And Psychological Researches
Factors associated with the phenomenon of marriage outside the court And the consequences of it A field study in Sadr City
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Marriage outside the court is a manifestation of the oppression that women are subjected to in Iraq its seriousness comes out of the consequences that it leads to The. It overlooks the age of the girl and her marriage in younger age or coerced to marry as it leads to neglecting the affordability of marital relationship as long as the marriage does not have any legal or material consequences. The present study aims to detect Characteristics of both wives, husbands and families Who agree to marry her daughters outside the court. And the reasons that lead them to marry outside the courts. It also aims to provide information on the circumstances of marriage and reasons for refusing to ratify it in court. The study was based on the sample soc

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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
The Situation of Refugees and Displaced Women in Arab Countries during Conflicts According to the Perspective of the Arab Women's Organization
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The scope of the humanitarian tragedies in the Arab region has widened after the conflicts that erupted over the past years, exacerbation to include educational, cultural, and social dimensions, economic and moral aspects of the displaced families, especially after the emergence of terrorist organizations and sectarian conflicts which overthrew human and led to various political and demographic changes, forcing citizens to leave their homes, fleeing with their families from the danger of murder, terrorism, and violation to other safer areas inside or outside their countries. Women and children were the vast majority of the displaced who were subjected to great pressures, The host communities bore the pro

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Publication Date
Sat Aug 01 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
Building and legalizing a test for evaluating the tactical learning of the footwork for the foil fencer in the fencing game
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AA wahid, journal mustansiriyah of sports science, 2023

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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of educational design design according to the theory of Ozbal in the acquisition of geographical concepts among the pupils of the fourth primary in the geography and development of their habits of mind
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Summary The objective of the research is to learn the design of a learning educational learning according to the theory of Ausubel in the acquisition of geographical concepts among the students of the fourth primary in the field of geography and the development of their habits of mind. To achieve this, the researcher relied on the two hypotheses the researcher used the design of equal groups the first experimental group was studied according to the design educational educational learning according to the theory and the other is an officer according to the traditional method. The research community consists of fourth grade pupils in primary school day for girls in the Directorate of Education Baghdad, Al-Rusafa, the third academic year 20

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Publication Date
Sun Dec 02 2018
Journal Name
Journal Of The College Of Education For Women
The Role of Local Satellite Channels in the formation of knowledge and trends of the Iraqi Public Towards Terrorism: A Field Study
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Terrorism is a global phenomenon that engulfs most regions of the world to varying degrees. Media outlets are aware of the many incidents of violence and terrorism that have increased in recent times. The differences between the size of the phenomenon in different societies are the causes and severity of the phenomenon. On the role of local satellite channels in shaping the knowledge and trends of the Iraqi public towards the events of terrorism, in light of the assumptions of reliance on the media. The importance of this study is that it assesses the role of local satellite channels in the formation of knowledge and trends The study seeks to know the extent of exposure of the Iraqi public to local satellite channels, and to reveal the e

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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
Degree of Practicing the Professional Leadership of the Faculties’ Deans, Their Deputies and Heads of the Scientific Divisions in Al-Qaseem University
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Abstract

The study aims to find out the degree of practicing professional leadership of the faculty’s deans, deputies, and heads of the scientific divisions at Al-Qaseem University. The study has adopted the descriptive analytical method. To achieve the objective of the study, the researcher developed a questionnaire consisting of (45) items distributed to six fields that were applied to a sample of (116) faculty deans, deputies, and the head of division at Al-Qaseem University. The results showed there is a high practicing degree of the study sample individuals of the professional leadership on the questionnaire’s fields as a whole, strategic thinking field came at the first rank, while the innovation, creat

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The Dental Caries Experience in Relation to Salivary Flow Rate, SIgA and Mutans Streptococci Bacteria in Smoker and Non-Smoker Patients
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Background: Dental caries is a localized, progressive destructive, largely irreversible microbial based disease of multifactorial nature; these factors include (host, microbes and food) they influence differently on the initiation and progression of dental caries. The aims of the study: was to evaluate the effect of smoking on salivary flow rate, secretory immunoglobulin (SIgA) level and viable count of mutans streptococci (M.S) bacteria in oral cavity and their relation to dental caries experience. Material and method: The samples were collected from 80 male students ranging in ages from 18-22 years old. Where they divided in to two groups, 40 non-smokers (control group) and 40 smokers (study group). Unstimulated salivary samples were c

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Publication Date
Sun Mar 01 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of reinsurance indicators on the financial surplus of the National Insurance Company: applied research in marine insurance / merchandise branch
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The research dealt with the impact of reinsurance on the financial surplus of the National Insurance Company by focusing on reinsurance in the marine insurance / merchandise branch. The aim of this research was to show the impact of reinsurance indicators (reinsurance ratios, retention ratios, commission rates earned) on reinsurance operations Data on the research variables were collected based on the inductive and deductive approach in the analysis of information for the financial reports of the National Insurance Company of the Marine Insurance Branch and the insurance portfolio (goods) for the period from 2010 to 2017, and for the purpose of obtaining results was used M a number of statistical methods commensurate with the nature of t

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