Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-27T21:39:19.815Z Has data issue: false hasContentIssue false
  • English
  • Français

Patient-controlled analgesia with lornoxicam vs. dipyrone for acute postoperative pain relief after septorhinoplasty: a prospective, randomized, double-blind, placebo-controlled study

Published online by Cambridge University Press:  01 March 2008

M. Sener ,
C. Yilmazer ,
I. Yilmaz ,
E. Caliskan ,
A. Donmez  and
G. Arslan
M. Sener*
Affiliation:
Baskent University, Faculty of Medicine, Department of Anesthesiology, Ankara, Turkey
C. Yilmazer
Affiliation:
Baskent University, Faculty of Medicine, Department of Otolaryngology, Ankara, Turkey
I. Yilmaz
Affiliation:
Baskent University, Faculty of Medicine, Department of Otolaryngology, Ankara, Turkey
E. Caliskan
Affiliation:
Baskent University, Faculty of Medicine, Department of Anesthesiology, Ankara, Turkey
A. Donmez
Affiliation:
Baskent University, Faculty of Medicine, Department of Anesthesiology, Ankara, Turkey
G. Arslan
Affiliation:
Baskent University, Faculty of Medicine, Department of Anesthesiology, Ankara, Turkey
*
Correspondence to: Mesut Sener, Baskent Universitesi Adana Seyhan Hastanesi, Anesteziyoloji ve Reanimasyon AD, Baraj yolu 1. durak no: 37, TR01140 Seyhan/Adana, Turkey. E-mail: mesutsenertr@yahoo.co.uk; Tel: +90 322 4586868 Ext. 1226; Fax: +90 322 4592622
Get access

Summary

Background and objective

We compared the efficacy of intravenous lornoxicam vs. dipyrone in patient-controlled analgesia for postoperative analgesia.

Methods

The study included 105 patients who had undergone elective septorhinoplasty after receiving general anaesthesia. Patients were divided into three groups to receive lornoxicam (24 mg day−1), dipyrone (5 g day−1) or placebo. Pain was evaluated using a 0–100 mm visual analogue scale at 2, 4, 6, 8, 12, 16, 20 and 24 h postoperatively. Pethidine (1 mg kg−1) was administered intramuscularly to patients requiring rescue analgesia. Pethidine requirements were recorded during the first 24 h postoperatively, and treatment-related adverse effects were noted.

Results

Postoperative pain scores were significantly lower with lornoxicam compared with dipyrone at 8 h (P = 0.016). No significant differences regarding pain scores at 2, 4, 6, 12, 16, 20 and 24 h were found. Significantly fewer patients in the lornoxicam group required rescue analgesics (vs. dipyrone, P = 0.046; vs. placebo, P = 0.001); fewer patients in the dipyrone group required rescue analgesics compared with placebo (P = 0.008). Significantly fewer patients in the lornoxicam group had nausea (vs. dipyrone, P = 0.022; vs. placebo, P = 0.006); no significant differences were found between the other two groups. Antiemetic use was significantly lower in the lornoxicam group (vs. dipyrone, P = 0.002; vs. placebo, P = 0.001).

Conclusions

Lornoxicam has better tolerability and is a more effective analgesic than dipyrone when administered by patient-controlled analgesia for postoperative analgesia after septorhinoplasty.

Keywords

PAIN POSTOPERATIVELORNOXICAMDIPYRONEANALGESIAPATIENT CONTROLLEDRANDOMIZED CONTROLLED TRIAL
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 3 , March 2008 , pp. 177 - 182
Copyright
Copyright © European Society of Anaesthesiology 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.White, PF . The changing role of non-opioid analgesic techniques in the management of postoperative pain. Anesth Analg 2005; 101 (Suppl 5): S5–S22.CrossRefGoogle ScholarPubMed
2.Kehlet, H, Dahl, JB. Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 2003; 362: 1921–1928.CrossRefGoogle ScholarPubMed
3.Carr, DB, Goudas, LC. Acute pain. Lancet 1999; 353: 2051–2058.CrossRefGoogle ScholarPubMed
4.Apfelbaum, JL, Chen, C, Mehta, SS, Gan, TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg 2003; 97: 534–540.CrossRefGoogle ScholarPubMed
5.Yilmaz, I, Sener, M, Yavuz, H et al. . Postoperative pain management in clinics of otolaryngology. Kulak Burun Bogaz Ihtis Derg 2006; 16: 1–16.Google ScholarPubMed
6.Kehlet, H, Dahl, JB. Are perioperative nonsteroidal anti-inflammatory drugs ulcerogenic in the short term? Drugs 1992; 44 (Suppl 5): 38–41.CrossRefGoogle ScholarPubMed
7.Hudcova, J, McNicol, E, Quah, C, Lau, J, Carr, DB. Patient controlled opioid analgesia versus conventional opioid analgesia for postoperative pain. Cochrane Database Syst Rev 2006; 4: CD003348.Google Scholar
8.Radhofer-Welte, S, Rabasseda, X. Lornoxicam, a new potent NSAID with an improved tolerability profile. Drugs Today (Barc) 2000; 36: 55–76.CrossRefGoogle ScholarPubMed
9.Skjodt, NM, Davies, NM. Clinical pharmacokinetics of lornoxicam. A short half-life oxicam. Clin Pharmacokinet 1998; 34: 421–428.CrossRefGoogle Scholar
10.Balfour, JA, Fitton, A, Barradell, LB. Lornoxicam. A review of its pharmacology and therapeutic potential in the management of painful and inflammatory conditions. Drugs 1996; 51: 639–657.CrossRefGoogle ScholarPubMed
11.Rosenow, DE, Albrechtsen, M, Stolke, D. A comparison of patient-controlled analgesia with lornoxicam versus morphine in patients undergoing lumbar disk surgery. Anesth Analg 1998; 86: 1045–1050.Google ScholarPubMed
12.Gong, ZY, Ye, TH, Qin, XT, Yu, GX, Guo, XY, Luo, AL. Patient-controlled analgesia with lornoxicam in patients undergoing gynecological surgery. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2001; 23: 472–475.Google ScholarPubMed
13.Zhao, H, Ye, TH, Gong, ZY, Xue, Y, Xue, ZG, Huang, WQ. Application of lornoxicam to patient-controlled analgesia in patients undergoing abdominal surgeries. Chin Med Sci J 2005; 20: 59–62.Google ScholarPubMed
14.Karaca, M, Kocoglu, H, Gocmen, A. Comparison of lornoxicam with tramadol in patient-controlled analgesia after gynecological surgery. Eur J Gynaecol Oncol 2006; 27: 78–80.Google ScholarPubMed
15.Levy, M, Zylber-Katz, E, Rosenkranz, B. Clinical pharmacokinetics of dipyrone and its metabolites. Clin Pharmacokinet 1995; 28: 216–234.CrossRefGoogle ScholarPubMed
16.Rodriguez, MJ, Delatorre, MR, Pereziraola, P et al. . Comparative study of tramadol versus NSAIDS as intravenous infusion for managing postoperative pain. Curr Ther Res 1993; 54: 375–383.CrossRefGoogle Scholar
17.Torres, LM, Rodriguez, MJ, Montero, A et al. . Efficacy and safety of dipyrone versus tramadol in the management of pain after hysterectomy: a randomized, double-blind, multicenter study. Reg Anesth Pain Med 2001; 26: 118–124.Google ScholarPubMed
18.Stamer, UM, Hothker, F, Lehnen, K, Stuber, F. Postoperative analgesia with tramadol and metamizol. Continual infusion versus patient controlled analgesia. Anaesthesist 2003; 52: 33–41.CrossRefGoogle ScholarPubMed
19.Balci, C, Karabekir, HS, Sivaci, RG, Toprak, D, Ela, Y, Pancaroglu, M. Comparing the efficiency of tramadol and lornoxicam in patient control analgesia at postoperative pain in patients undergoing lumbar disc surgery. Türk Anest Rean Der Dergisi 2006; 34: 228–235.Google Scholar
20.Nikoda, VV, Maiachkin, RB, Bondarenko, AV. Clinical aspects of using patient-controlled analgesia with nonsteroidal anti-inflammatory agents in postoperative period. Anesteziol Reanimatol 2003; 5: 56–59.Google Scholar
21.Torres, LM, Collado, F, Almarcha, JM, Huertas, VG, de Antonio, P, Rodriguez, M. Treatment of postoperative pain with intravenous PCA system. Comparison with morphine, metamizole, and buprenorphine. Rev Esp Anestesiol Reanim 1993; 40: 181–184.Google ScholarPubMed
22.Montes, A, Warner, W, Puig, MM. Use of intravenous patient-controlled analgesia for the documentation of synergy between tramadol and metamizol. Br J Anaesth 2000; 85: 217–223.Google ScholarPubMed
23.Watcha, MF, White, PF. Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology 1992; 77: 162–184.CrossRefGoogle ScholarPubMed