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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
Sat Aug 01 2026
Journal Name
The American Journal Of Cardiology
Lipoprotein(a) Distribution Across Race/Ethnicity and Association With Mortality Outcomes in NHANES III (1988 to 1994) With Follow‑Up to 2019
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Publication Date
Fri Jan 01 2021
Journal Name
E3s Web Of Conferences 318, 03006 (2021)
Effect of External Post-Tensioning Strengthening Technique on Flexural Capacity of Simple Supported Composite Castellated Beam
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This research is carried out to study the effect of the external post-tensioning technique on the flexural capacity of simply supported composite castellated beam experimentally. In this research, seven composite castellated beams having the same dimensions and material properties were cast and tested up to failure by applied two concentrated loads at 700 mm from each end. Two external strands of 12.7 mm diameter were fixed at each side of the web of strengthening beams and located at depth 180 mm from top fiber of the section (dps) at each end of the beam. The strands have been tensioned by using a hydraulic jack with a constant stress of 100 MPa. This research aims to study the effect of the strengthening by different shapes of st

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Wed Nov 08 2023
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Correlation of Mercury With Some Biochemical Parameters in Serum of Mothers and Their New Born Children
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Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Cognitive Distortion And Its Relationship of Parenting Reinforcement For Kindergarten Children
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This research aims to identify the cognitive distortion of kindergarten children and its relationship to their parenting reinforcement. The researcher used the descriptive approach, being the closest to reaching the study objectives, To measure the relationship between the research variables, the researcher prepared two questionnaire tools for this purpose, the first for measuring "cognitive distortion", And the second is to measure "parental reinforcement", and each tool consisted of (20) items.                         

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Publication Date
Sat Dec 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
The Impact of Breastfeeding Duration on the Development of Normal Occlusal Features of the Primary Dentition among Baghdad Preschool Children
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Background: Normal occlusal features of primary dentition are crucial for normal development of the permanent dentition. Breastfeeding is an important factor for both general and dental health of children. Aim: The aim of the present study is to assess the impact of the breastfeeding duration on the prevalence of normal occlusal features of the primary dentition among preschool children in Baghdad. Materials and Methods: The sample was 630 Iraqi children (270- boys, 360 girls), aged 3-5 years selected from four kindergartens in Baghdad city. The study was carried out through questionnaire and clinical examination. Normal occlusal features were examined as the presence or absence of interincisive spaces (IS) and primate spaces (PS), termi

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Mon Aug 15 2022
Journal Name
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Virulence and antimicrobial resistance of Escherichia coli isolated from Tigris River and children diarrhea
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Publication Date
Sat Jun 15 2019
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Oral hygiene status in relation to salivary estradiol hormone level among pre-menopausal and post-menopausal Iraqi women
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Background: The menopause is physiological changes in women that give rise to adaptive changes at both systemic and oral level. During menopause, ovarian function declines and the production of sex steroid hormones reduces significantly affecting the oral tissues and periodontal structures leading to chronic inflammation of the gingiva, increased risk of tooth loss. Aim of study: The present study was designed to estimate the oral hygiene status in relation to salivary estradiol level among pre and post-menopausal women. Materials and Methods: Ninety women aged 48-52 years old, the control group consisted of 45 pre-menopausal women and the study group consisted of 45 post-menopause were examined for gingival index, plaque index and calcu

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Publication Date
Fri Jun 30 2023
Journal Name
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The strategy of applying quality indicators to educational outcomes according to market requirements - a fundamental study
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A research study in which a methodology for quality indicators that can be adopted to evaluate the educational process in educational institutions within a specific strategy helps individuals in charge of educational education to make appropriate decisions based on accurate and properly approved plans to achieve successful outcomes.

These indicators can be used to judge the quality of educational institutions in order to improve, improve and develop them. This study has concluded the necessity of putting quality into actual application in order to benefit from it in evaluating the future action of Iraqi educational institutions.

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Publication Date
Thu Jan 19 2023
Journal Name
Plos One
Knowledge sharing behaviour among head nurses in online health communities: The moderating role of knowledge self-efficacy
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Background

Head nurses are vital in understanding and encouraging knowledge sharing among their followers. However, few empirical studies have highlighted their contribution to knowledge-sharing behaviour in Online Health Communities (OHCs). In addition, scant literature has examined the moderating role of knowledge self-efficacy in this regard.

Purposes

This study examines the moderating role of self-efficacy between the association of four selected individual factors of head nurses (i.e., Trust, Reciprocity, Reputation, and Ability to Share) and their knowledge-sharing behaviour in OHCs in Jordan.

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