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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
Tue May 16 2023
Journal Name
Political Sciences Journal
The Dens of Extremism and Terrorism in Syrian Camps (Al-Hol as a model)
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After the defeat of the military terrorist organization "ISIS" and the fall of the throne of its alleged state in the Iraqi city of Nineveh, in Syrian Baghouz, and the end of its control over the land, the Syrian camps, especially "Al-Hol" camp, emerge as an incubator for the ideology of the terrorist organization "ISIS" and a vital base for its consolidation and dissemination, which includes (68,000- 73,000) people. During the years following the military defeat of (ISIS), the camp witnesses the spread of extremist ideas widely at the hands of its residents, including the families of the organizations dead's, extremist detainees, and those who deal with it, taking advantage of the deterioration of the environmental, se

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Publication Date
Wed Sep 30 2015
Journal Name
College Of Islamic Sciences
Message in the tune of readers and denial to those who say infidelity tunes
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Message in the tune of readers and denial to those who say infidelity tunes

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Publication Date
Mon Sep 01 2003
Journal Name
Iraqi Journal Of Tropical Disease Researches
The isolation and identification of some pathogenic bacteria from clinical cutaneous infection in human
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Publication Date
Mon Feb 25 2019
Journal Name
Iraqi Journal Of Physics
Influence of electrodes area ratios and the discharge volume in RF capacitively coupled plasma
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Experimental results on harmonic distortions in 13.56 MHz RF Argon glow discharge using different grounded electrodes areas and electrodes spacing are presented. The experiment is carried out at four pressure values. RF power values used are between 20 and 90 watts. The results indicate significant increase in distortions at two specific values of the cone angle enclosing the two electrodes within its geometrical volume. The computation of the cone head angle gave the symmetry discharge or asymmetry as well as when the angle is small the condition is near symmetry discharge associated with decrease in the nonlinearity.

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Publication Date
Fri Dec 22 2017
Journal Name
Pakistan Journal Of Biotechnology
THE ROLE OF HLA-DRB 1 ALLELE IN HYPOTHYROID PATIENTS WITH AND WITHOUT PERIODONTITIS
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Hypothyroidism is a frequent disorder in the general population, especially among women, is defined as adeficiency of thyroid activity that results from insufficient production or action of thyroid hormones leading to a totaldecrease of metabolic. Human leukocyte antigen is the most polymorphic genetic system in man. Genes of this regioninfluence susceptibility to certain diseases.Objectives: The purpose of the present study is to investigate the role of HLA-DRB1 genotyping in hypothyroidpatients with and without periodontitis. Sixty hypothyroid patients 30 of patients were with periodontitis and 30without periodontitis compare with 30 healthy subjects as control enrolled in this study. DNA was extracted fromblood samples, then HLA- genotyp

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Publication Date
Wed May 18 2016
Journal Name
Al-academy
Metaphoric assimilation of the place and its total functioning in scenario: إيهاب ياسين طه
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Abstract: The study of the place is hardly a concern for most researchers in the art generally. It is hardly devoid of any movie of some configuration elements that are essential to him about and place one of them, and we find an echo location consists ago to begin screenwriter put Sightseeing begins features emerge there will be functioning simple scenario what would soon receive a growing Cummings final picture film. Metaphoric place begins to emerge in the form of linguistic scenario is soon to be translated in another language, the language of the image. Which in turn complement the creative process of this art and have a significant impact in terms of content and curriculum and installation in and it even to seek the true meaning fu

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Publication Date
Wed Mar 27 2013
Journal Name
Engineering And Technology Journal
Total and Matric Suction in Unsaturated Soil with the Existence of Different Salts Content
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Publication Date
Sun Jul 03 2011
Journal Name
Journal Of Educational And Psychological Researches
Educational activities in the role of government nurseries and its relationship to some variables
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The skill of management educational activities gradually grow with the experience, but they differ from personal skill educator to another, because each style nanny personally and the way to work. There educator and active movement and vitality that look like happiness and clear during the implementation of the activity, and the other runs educational activities quietly, efficiently and without emotion and clear (dry, 2001: p. 274). And the stage of childhood is one of the most important stages that are based upon the future life as a whole because the man also confirmed by the School of analysis psychological is the son of his childhood and the best example to us what the Holy Prophet Muhammad (peace be upon him): (Every child i

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Publication Date
Sun Jun 02 2019
Journal Name
Baghdad Science Journal
Histological Changes in the Lung and Liver of Mice Treated with Brake Pad Particles
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In the present study, the effects of brake pad particles of lung and liver histological sections were evaluated for (60) adult male mice. The animals were divided into three groups ( A,B,C) according to the periods of exposure (4, 8, and 12) weeks respectively exposed to brake pad particles in addition to the control groups (F) exposed to fresh air only. A special inhalation chamber designed locally has been used to expose the animals. The exposure to brake pad particles was (2.228) µg/m³ for 30 min/day, 5 days/week for (4,8and12) weeks respectively.

The examination in group (A) of the histological sections of the lung showed the thickness of interalveolar septa.  Also, a congestion of alveolar capillary was marked indicat

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Publication Date
Thu Dec 01 2011
Journal Name
Journal Of Engineering
SIMULATION MODEL FOR THE ASSESSMENT OF DIRECT AND INDIRECT GEOREFERENCING TECHNIQUES IN ANALYTICAL PHOTOGRAMMETRY
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This paper compares between the direct and indirect georeferencing techniques in Photogrammetry bases on a simulation model. A flight plan is designed which consists of three strips with nine overlapped images for each strip by a (Canon 500D) digital camera with a resolution of 15 Mega Pixels.

 

The triangulation computations are carried out by using (ERDAS LPS) software, and the direct measurements are taken directly on the simulated model to substitute using GPS/INS in real case. Two computational tests have been implemented to evaluate the positional accuracy for the whole model and the Root Mean Square Error (RMSE) relating to (30) check points show that th

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