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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
Sun Sep 05 2010
Journal Name
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Effect of Time Factor, Molybdenum and Potassium on Rhizobium Growth in the Soil
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Publication Date
Tue Feb 24 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Selected salivary constituents, physical properties and nutritional status in relation to dental caries among 4-5 year’s old children (Comparative study)
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Background: Tooth decay is still one of most common diseases of childhood, child’s primary teeth are important even though they aretemporary. This study was conducted to assess the physiochemical characteristic of saliva among caries experience preschool children and compared them with caries free matching in age and gender. Then an evaluation was done about these salivary characteristics to dental caries and evaluated the relation of body mass index to dental caries and to salivary variables. Materials and method: After examination 360 children aged 4-5 years of both gender. Caries-experiences was recorded according to dmfs index by (World Health Organization criteria 1987) during pilot study children with caries experience was di

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Publication Date
Tue Dec 15 2020
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Novel Coronavirus Pandemic as it is Expressed by Children in Their Drawings On-line: An Analytical Study: نزار بن صالح أحمد عبد الحفيظ
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This study aimed at identifying how children express the emerging coronavirus in general and according to their age groups (4-13 years) by analyzing 91 of their drawings published online, using the descriptive content analytical approach. The results showed that children's artistic expression of the virus came according to the concepts and ideas they carried about the virus for the age groups of (4-7 years) and (7-9 years), while it came according to visual perception for age groups (9-11 years), and from (11-13) years. Also, most children were aware about the presence of the virus and its widespread around the world, but (99%) of them do not realize the seriousness of the virus. It was confirmed that between (25-34%) of children were su

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Publication Date
Sun Sep 30 2012
Journal Name
College Of Islamic Sciences
The fundamentalists' position on the absolute prohibition and its impact          In different jurisprudence
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Tue Nov 24 2015
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Iraqi Journal Of Market Research And Consumer Protection
The role of e-commerce in the insurance industry and its impacts on consumer rights (In the case of the National Insurance Company study): The role of e-commerce in the insurance industry and its impacts on consumer rights (In the case of the National Insurance Company study)
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Thu Jul 28 2022
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Publication Date
Fri Nov 09 2018
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Publication Date
Tue Aug 15 2023
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Publication Date
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The demand for expatriate labor to Iraq increased after 2003 as a result of the openness that Iraq experienced, but this expatriate labor, which was requested at an increasing rate, has had economic, social, and political effects on the Iraqi economy in general, and the Iraqi labor market in particular. This is due to the high rates of unemployment, as most of these expatriate workers cause competition to local labor, and thus cause repercussions on the Iraqi economy as a whole, except for those expatriate workers coming with companies working in the oil sector. Iraq's GDP

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