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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 Sep 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Studying and analysis effect level of the Government expenditure and Gross Domestic product in size of the expenditure on the higher education in Iraq (1995 – 2009)
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The education, especially higher education, is an essentially factor in the progress of any society, if we consider the higher education, represents the top  of  the education`s  pyramid which take part in developing the human  resources and provide the human staff to raise the productive efficiency, and improve the social , economic level                                  

In order to face the increasing importance of higher education, great capabilities and expenditures must be available in a continous way, such expe

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
Developing the Skill of Friendship for Kindergarten Children in the Light of Bandura's Theory Social Learning: Ministry of Education / Baghdad Directorate of Education, Al/Rusafa
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The current research aims to identify the effect of the program to develop the skill of friendship among kindergarten children, as well as the scope of the impact of the program on the sample. To achieve the objectives of the research, the researcher hypothesizes there is no significant difference between the average scores of the sample members on the friendship skill scale for the dimensional scale according to the experimental and control group. The research sample consisted of (60) girl and boy with age ranges (4-6) who were randomly selected from the Kindergarten Unity at Baghdad city/ Rusafa 1. The children were distributed into an experimental and control group, each group consists of (30) girl and boy. The two groups were chosen

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Establishment of method and the development of the teaching methods in the late abbissid period and it s impact on the contemporary leading methods
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Every researcher must say that the world in continually progress toward the best and that
the Arab and Islamic civilization had produced much of systems and virtuous educational
practices which raised from Islamic heritage. This nation was not isolated from external
world, but it was made a clear active for promote the banner of other nations which entered
under her influence to promote Islamic banner and Muslims. Consequently also Muslims are
affected and influenced, this resulted a clear impact in the civilization and educational
ideology especially in the contemporary teaching methods.

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Publication Date
Wed Apr 01 2020
Journal Name
International Journal Of Psychosocial Rehabilitation,
The Effect of Using Resistance and Medical Ozone Training on Testosterone and Some Physiological Variables in Swimmers
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م.د. فاطمة حميد ،أ.م.د وفاء صباح محمد الخفاجي, International Journal of Psychosocial Rehabilitation,, 2020 - Cited by 1

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Building a Visual Test for Kindergartens’ children
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The present research aimed to test the imagination of children, and may build sample consisted of (400) a baby and child, selected by random way of four Directorates (first Resafe, second Resafe ,first alkarkh , second alkarkh), in order to achieve the objective of research the tow researchers have a test of imagination and extract the virtual and honesty plants distinguish paragraphs and paragraphs and difficulty factor became the test consists of (32), statistical methods were used (Pearson correlation coefficient, coefficient of difficult passages, highlight paragraphs, correlation equation, an equation wrong Standard) the tow researchers have a number of recommendations and proposals.

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Publication Date
Mon Feb 23 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The effects of bisphosphonate administration on teeth development and growth of the jaw bones in neonatal rats (histological and immunohistochemical study)
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Background: Bisphosphonates are potent inhibitors of osteoclastic bone resorption and widely used for the treatment of osteoporosis, and osteogenesis imperfecta in children. Clinical and experimental studies have demonstrated that Bisphosphonates delay or inhibit tooth eruption. This study tries to focus on the effect of bisphosphonate on teeth development and jaw bones growth. Materials and methods: The present study includes 65 neonatal rats during lactation period from 15 Albino Wister rats mother. Alendronate (one type of Bisphosphonates) was administrated orally (15 mg/kg) into 10 pregnant rats two times a week, while other 5 rats regard as control. Then the neonatal rats sacrificed in I, 6, 11, 16 and 21 days. The lower first molar we

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Publication Date
Sun Jun 20 2021
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
ON THE ECOLOGY AND SPECIES DIVERSITY OF THE FRESHWATER GASTROPODS OF SPRINGS IN ANDIJAN REGION, UZBEKISTAN
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This study examines the species composition, biodiversity, zoogeography, and ecology of freshwater gastropods of 12 springs in Andijan region of Uzbekistan. The study used generally accepted malacological, faunistic, ecological, analytical, and statistical methods. As a result of research in the springs, 14 species of freshwater gastropods belonging to 2 subclasses, 5 families, and 10 genera were recorded. 7 of them are endemic to Central Asia. When indicators of biodiversity of mollusks were analyzed according to the Shannon index, it was found that the highest value was recorded in the springs besides the hills. According to the biotope of distribution and bioecological features, they were divided into cryophilic, phytophilic, pelophil

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Publication Date
Thu Jun 01 2023
Journal Name
Baghdad Science Journal
Biochemical Study on the Impact of Radiation-induced Oxidative Stress on Radiographers in the X-ray and CT-scan Departments
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The consequences of ionizing radiation-induced oxidative stress on radiographers in X-ray and CT-scan departments utilizing several biochemical were analyzed. The study found highly considerable discrepancies in the interplay between radiation levels and gender in terms of mean Malondialdehyde (MAD), Vitamin D3 (Vit.D3), Triiodothyronine (T3), Thyroxine (T4), and High-Density Lipoprotein (HDL), but not Thyroid Stimulating Hormone (TSH), cholesterol, triglyceride (TG) and Low-Density Lipoprotein (LDL). The findings indicated that malondialdehyde is a useful biomarker for assessing oxidative stress in radiographers with exposure to ionizing radiation.

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The History of Multi Parties and its Effect on Political System in India
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The History of Multi Parties and its Effect on Political System in India

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Publication Date
Sat Apr 26 2025
Journal Name
Ii. Internationaldubai Social Sciences Andhumanities Congress
PTSD AND THE IMPACT OF VIOLENCE ON INDIVIDUAL'S PSYCHE IN SELECTED WAR NOVELS
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