lornoxicam and Pain--Postoperative

Non-steroidal anti-inflammatory drugs (NSAIDS) are commonly used for acute pain management. Lornoxicam is a nonselective NSAID for oral and intravenous administration. It has been available for human use since two decades and there is a growing body of evidence supporting its efficacy and tolerability for management of acute pain.. Public domain literature around the clinical use of lornoxicam for acute pain management has been reviewed.. There are a growing number of clinical studies documenting lornoxicam effects for short-term treatment of acute postoperative pain following various surgical procedures. It has in the majority of comparative studies been shown superior as compared to paracetamol, non-inferior compared to other NSAIDs, and commonly similarly effective as standard clinical doses of opioids, but associated with better tolerability. Its effect on other acute pain, for example, headache, back pain, or sports injury is not well studied. Lornoxicam 8 mg twice daily is a seemingly effective and tolerable alternative NSAID for use as sole agent or as part of multimodal analgesia in adults. Available data does however not show any outstanding benefits or special risk. The general precautions with regard to the use of NSAIDs, the potential risks, for example, gastrointestinal bleeding and or cardiovascular side effects must be acknowledged.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Drug Interactions; Humans; Musculoskeletal Pain; Pain, Postoperative; Piroxicam

Nonsteroidal anti-inflammatory drugs have peripheral analgesic effects. We compared the efficacy of peritonsillar infiltration versus intravenous (i.v.) lornoxicam on pain relief after tonsillectomy in adults.. Sixty adult patients scheduled for tonsillectomy were randomly assigned into three groups in a double-blind placebo-controlled study. In the control group, the patients received i.v. and peritonsillar saline infiltration; in the infiltration group, they received i.v. isotonic saline and peritonsillar lornoxicam infiltration, whereas in the i.v. group they received i.v. lornoxicam and peritonsillar saline infiltration. Pain verbal analogue scale at rest and on swallowing, the time to the first postoperative analgesic request, the total postoperative analgesic consumption during the first 24 h, intraoperative blood loss and postoperative bleeding were evaluated.. Preoperative lornoxicam administration resulted in a significant reduction in pain scores postoperatively in the infiltration and i.v. groups with no significant difference between them. The time to first postoperative analgesic request was 143 +/- 138 min in the control group compared with 684 +/- 328 and 750 +/- 316 min in the i.v. and infiltration groups, respectively; P value is less than 0.05. Similarly a higher total paracetamol consumption (2632 +/- 1065 mg) during the first postoperative day was recorded in the control group than in both the lornoxicam groups (1300 +/- 733 and 1600 +/- 754 mg), with no significant differences between the i.v. and infiltration groups. Comparable intraoperative blood losses with no posttonsillectomy bleeding were recorded in the three study groups.. Peritonsillar infiltration or i.v. lornoxicam enhanced postoperative analgesia after tonsillectomy in adults. However, the analgesic efficacy of locally applied lornoxicam is not superior to the i.v. administration.

Topics: Adult; Analgesia; Analgesics; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Infusions, Intravenous; Male; Pain, Postoperative; Piroxicam; Placebos; Postoperative Complications; Time Factors; Tonsillectomy

Lornoxicam is one of the oxicam class of non-steroidal anti-inflammatory drugs (NSAIDs), producing analgesic and antipyretic effects in part through the non-selective inhibition of cyclo-oxygenase-1 and -2. It is prescribed for osteoarthritis, rheumatoid arthritis, acute lumbar-sciatica conditions and for postoperative pain management. Lornoxicam is available in 31 countries in Europe, the Middle East, Far East and South America, and is becoming more widely available.. To assess the efficacy, the time to onset of analgesia, the time to use of rescue medication and any associated adverse events of single dose oral lornoxicam in acute postoperative pain.. We searched CENTRAL, MEDLINE, EMBASE and PubMed to June 2009.. Single oral dose, randomised, double-blind, placebo-controlled trials of lornoxicam for relief of established moderate to severe postoperative pain in adults.. Studies were assessed for methodological quality and the data extracted by two review authors independently. Summed total pain relief over 6 hours (TOTPAR 6) was used to calculate the number of participants achieving at least 50% pain relief. These derived results were used to calculate, with 95% confidence intervals (CIs), the relative benefit compared to placebo, and the number needed to treat (NNT) for one participant to experience at least 50% pain relief over 6 hours. Numbers of participants using rescue medication over specified time periods, and time to use of rescue medication, were sought as additional measures of efficacy. Information on adverse events and withdrawals was collected.. Three studies, with 628 participants, met the inclusion criteria; 434 participants were treated with various doses (2 mg to 32 mg) of lornoxicam, 118 with placebo, and 76 with other active therapies. All the participants had pain following third molar extraction, and study duration was 8 to 24 hours. The NNT for at least 50% pain relief over 6 hours after a single dose of lornoxicam 8 mg was 2.9 (2.3 to 4.0). There were insufficient data to analyse other doses or use of rescue medication. No serious adverse events or withdrawals were reported by any of the studies.. Oral lornoxicam is effective at treating moderate to severe acute postoperative pain, based on limited data. Adverse events did not differ significantly from placebo.

Topics: Acute Disease; Administration, Oral; Adult; Analgesics, Non-Narcotic; Anti-Inflammatory Agents, Non-Steroidal; Humans; Pain, Postoperative; Piroxicam; Randomized Controlled Trials as Topic

Topics: Acute Disease; Analgesics; Analgesics, Opioid; Animals; Anti-Inflammatory Agents, Non-Steroidal; Bite Force; Calcitonin Gene-Related Peptide; Disease Models, Animal; Dose-Response Relationship, Drug; Drug Evaluation; Humans; Mandible; Molar, Third; Morphine; Movement; Neuropeptides; Pain Threshold; Pain, Postoperative; Piroxicam; Rats; Substance P; Tooth Extraction

Lornoxicam (chlortenoxicam), a new nonsteroidal anti-inflammatory drug (NSAID) of the oxicam class with analgesic, anti-inflammatory and antipyretic properties, is available in oral and parenteral formulations. It is distinguished from established oxicams by a relatively short elimination half-life (3 to 5 hours), which may be advantageous from a tolerability standpoint. Data from preliminary clinical trials suggest that lornoxicam is as effective as the opioid analgesics morphine, pethidine (meperidine) and tramadol in relieving postoperative pain following gynaecological or orthopaedic surgery, and as effective as other NSAIDs after oral surgery. Lornoxicam was also as effective as other NSAIDs in relieving symptoms of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute sciatica and low back pain. Lornoxicam has a tolerability profile characteristic of an NSAID, with gastrointestinal disturbances being the most common adverse events. Limited clinical experience to date suggests that, as with a number of other NSAIDs, lornoxicam may provide a better-tolerated alternative or adjuvant to opioid analgesics for the management of moderate to severe pain. It has also demonstrated potential as an alternative to other NSAIDs for the management of arthritis and other painful and inflammatory conditions. These preliminary findings require confirmation in further comparative and long term studies.

Topics: Absorption; Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Rheumatoid; Dosage Forms; Drug Interactions; Humans; Low Back Pain; Migraine Disorders; Osteoarthritis; Pain; Pain, Postoperative; Piroxicam; Spondylitis, Ankylosing; Tissue Distribution

Management of postoperative pain has become a growing concern, even for minor gynecological procedures. Proper postoperative pain management has been shown to lead to earlier mobilization, shortened hospital stay, and increased patient satisfaction. The optimal means of reducing the pain of pregnancy termination has not yet been determined.. To compare the efficiency in pain management of two drugs, lornoxicam and paracetamol, given intravenously postoperatively to women who underwent abortion with dilation and curettage.. The cohort comprised 80 women scheduled for dilation and curettage for pregnancy termination at 6-12 gestational weeks. The anesthesiologist gave 1000 mg paracetamol or 20 mg lornoxicam soon after starting the procedure, according to a randomization table. The medical staff and the patients were blinded to the drug that was administered. Pain levels were evaluated by a 10 cm visual analogue scale (VAS) at 15, 30, 60, 90, and 120 minutes following arrival at the postoperative care unit.. Mean levels of pain decreased from 60 minutes postoperative until the end of recording, reaching minimum levels at 120 minutes: 0.8 ± 0.19 and 1.5 ± 0.28, for lornoxicam and paracetamol, respectively. The differences between the groups were statistically significant (P < 0.05 from 60 minutes after the procedure until the time of discharge.. Compared to women who received paracetamol, women who received lornoxicam after dilation and curettage for termination of pregnancy reported lower levels of pain, from 30 minutes postoperative until the time of discharge following the procedure.

Topics: Abortion, Induced; Acetaminophen; Dilatation and Curettage; Female; Humans; Pain, Postoperative; Pain, Procedural; Piroxicam; Pregnancy

The aim of this study was to establish whether the pre-emptive use of lornoxicam (16mg) in third molar surgery ensures successful postoperative analgesia and reduces rescue analgesic intake when compared to postoperative application, and in comparison with placebo. Ninety patients were split randomly into three groups: group A received lornoxicam 60min before surgery and placebo 60min after surgery; group B received placebo 60min before surgery and lornoxicam 60min after surgery; group C received placebo 60min before surgery and placebo 60min after surgery. Postoperative pain was recorded on a visual analogue scale and on a numerical rating scale at 1, 2, 4, 6, 8, 12, and 24h after surgery. The patients recorded total dose of paracetamol intake during the 24h after the procedure. The efficacy of postoperative analgesia was greater in lornoxicam groups when compared to the placebo group; there was no difference between the two lornoxicam groups (A and B). Patients in group C took their first rescue analgesic dose earlier after surgery than patients in the two lornoxicam groups. The average dose of paracetamol taken in group C was 1000mg, while it was500 mg in the lornoxicam groups.

Topics: Adolescent; Adult; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Male; Mandible; Middle Aged; Molar, Third; Pain Measurement; Pain, Postoperative; Piroxicam; Prospective Studies; Tooth, Impacted; Treatment Outcome

The aim of the present randomized, placebo-controlled study was to compare postoperative analgesic effects of peroperative paracetamol and lornoxicam administration.. Sixty adult patients with American Society of Anesthesiologists (ASA) risk classification I-II, who would undergo single-level lumbar discectomy under general anesthesia, were enrolled. Patients were administered either 1000 mg paracetamol (Group P), 8 mg lornoxicam (Group L), or saline (Group C) prior to induction of anesthesia (n=20 for all groups). All patients were administered the same anesthesia induction and maintainance. Postoperative analgesia was maintained with the same analgesic drug in each group. Rescue analgesia was supplied with intravenous meperidine delivered by a patient-controlled analgesia device. Numeric rating score (NRS) results, first analgesic demand time, and cumulative meperidine consumption were recorded postoperatively. Primary outcome was NRS at first postoperative hour. Secondary outcome was measure of opioid consumption during first 24 postoperative hours.. At first postoperative hour, NRS of Group L [4 (0-8)] was lower than NRSs of Groups P and C [6(0-7); 6(0-9), respectively; p<0.016]. Time to first analgesic demand of Group L was longer, compared with those of the other groups (p<0.016). Cumulative postoperative meperidine consumption in Group L was less than those of Groups P and C at 2-, 12-, and 24-hour time intervals (p<0.016), while Groups P and C had similar findings for the same time intervals.. Preoperative lornoxicam administration decreased early postoperative pain scores more effectively than paracetamol.

Topics: Acetaminophen; Adult; Aged; Analgesia, Patient-Controlled; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Female; Humans; Infusions, Intravenous; Intraoperative Care; Lumbar Vertebrae; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam; Prospective Studies; Treatment Outcome

The administration of drugs by patient-controlled analgesia (PCA) is routinely practiced for the management of postoperative pain. It is common for 2 or more drugs to be combined in PCA solutions. The combination of analgesics and antiemetic agents is frequently required. Unfortunately, the compatibility and stability of lornoxicam and antiemetic agents, such as droperidol, ondansetrone, granisetron, and tropisetron, has not been determined. The aim of this study was to evaluate the compatibility and stability of solutions containing lornoxicam with the 4 antiemetic agents in combination for PCA administration.In our study, test samples were prepared in triplicate by adding 40 mg lornoxicam and 5 mg droperidol, 8 mg ondansetron, 6 mg granisetron, or 5 mg tropisetron to 100-mL polyolefin bags of sodium chloride 0.9% and stored at 25 °C. The analgesic mixture samples were visually inspected for precipitation, cloudiness, and discoloration at each sampling interval. Drug concentrations were determined using high-performance liquid chromatographic (HPLC) analysis.No loss of lornoxicam occurred with any of the 4 antiemetic agents tested for up to 48 hours. However, the contents of droperidol, ondansetron, granisetron, and tropisetron were significant loss >48 hours. After storage of 4.0 to 48.0 hours, the presence of a slight precipitate was observed in all the injection combinations.The results indicate that combinations of lornoxicam with droperidol, ondansetrone, granisetron, or tropisetron in infusion solution during simulated intravenous PCA administration were incompatibility when stored protected from light at 25 °C.

Topics: Analgesia, Patient-Controlled; Anti-Inflammatory Agents, Non-Steroidal; Antiemetics; Drug Incompatibility; Drug Stability; Drug Storage; Drug Therapy, Combination; Humans; Infusions, Intravenous; Pain, Postoperative; Patient Simulation; Piroxicam; Polyenes

The present study sought to compare the analgesic efficacy and adverse effects of intravenous (IV) lornoxicam and tramadol to investigate if lornoxicam is a reasonable alternative to a weak opioid for post-thyroidectomy pain.. Fifty patients of American Society of Anesthesiologists class I or II, 18 to 65 years of age, and who underwent thyroidectomy were assigned to 2 groups in a randomized manner. Group L received 8 mg of lornoxicam IV and Group T received 1 mg/kg of tramadol IV at conclusion of the operation. Pain intensity of patients was recorded at 15 and 30 minutes, and at 1, 2, 3, 4, 6, 12, and 24 hours after the initial dose with Numerical Rating Scale (NRS) and Ramsey Sedation Scale. Electrocardiogram, heart rate, systolic/diastolic and average artery pressure and peripheral oxygen saturations were monitored continuously during this period. Patients completed satisfaction questionnaires at 24th hour.. Both drugs produced acceptable analgesia; however, significantly fewer patients reported 1 or more adverse events with lornoxicam than with tramadol. Most commonly seen in Group T was nausea/vomiting. NRS scores at 15 minutes, 30 minutes, and 1 hour were lower in Group L than in Group T (p<0.05), but there was no significant difference between groups after postoperative first hour. First analgesic requirement time was significantly longer in Group L compared to Group T (p<0.001). No serious complications were seen in either group.. Lornoxicam is a safe and effective analgesic that may be used with fewer complications than low-dose tramadol for treatment of moderate to severe postoperative pain.

Topics: Adolescent; Adult; Aged; Analgesics; Female; Humans; Infusions, Intravenous; Male; Middle Aged; Pain, Postoperative; Piroxicam; Surveys and Questionnaires; Thyroidectomy; Tramadol; Treatment Outcome; Young Adult

The main purpose of the study was to test whether the combination of gabapentin (600 mg 4 hours before surgery, 600 mg after 24 hours), ketamine (0.3 mg/kg before anesthesia), lornoxicam (8 mg before anesthesia and 8 mg/12 hours), and local ropivacaine (5 mL 7.5% at insertion sites) provides superior analgesia to each of these drugs alone in the first 24 hours after laparoscopic cholecystectomy. The secondary purpose was to examine whether this combination has less opioid-related side effects.. This was a 2-center randomized placebo-controlled trial. One hundred forty-eight patients, between 18 and 70 years of age, were randomly assigned to 6 groups (28 in each group) with the use of computer software: A(gabapentin/ketamine/lornoxicam/ropivacaine); B(gabapentin/placebo/placebo/placebo); C (placebo/ketamine/placebo/placebo); D (placebo/placebo/lornoxicam/placebo); E (placebo/placebo/placebo/ropivacaine); and F (placebo/placebo/placebo/placebo). Only the principal investigator was aware of patients' allocation and provided drugs and placebo in covered prefilled syringes. The primary outcome of the study was the 24-hour morphine consumption. Secondary outcomes were frequency of opioid-related side effects (nausea, vomiting, sedation, pruritus, and dysuria).. Only groups A (6.4 mg), B (9.46 mg), and D (9.36 mg) had lower morphine consumption than control group (20.29 mg) (P < 0.001, P = 0.01, and P = 0.008, respectively). Group A was not different from B and D (P = 0.92, P = 0.93). The only difference was in episodes of nausea between groups A (n = 5) and the control group (n = 12) (P = 0.018).. The combination of gabapentin, ketamine, lornoxicam, and local ropivacaine does not provide superior analgesia than gabapentin alone or lornoxicam alone after laparoscopic cholecystectomy. The combination reduces only the frequency of postoperative nausea, but larger studies are needed for safer results.

Topics: Adult; Amides; Amines; Cholecystectomy, Laparoscopic; Cyclohexanecarboxylic Acids; Double-Blind Method; Drug Therapy, Combination; Female; Gabapentin; gamma-Aminobutyric Acid; Humans; Ketamine; Male; Middle Aged; Pain Management; Pain Measurement; Pain, Postoperative; Piroxicam; Ropivacaine

To evaluate the risk of peri-operative bleeding and re-intervention with peritonsillar lornoxicam infiltration in paediatric tonsillectomy.. Prospective, randomised, double-blinded, placebo-controlled, split-body study.. University hospital.. A total of 68 patients (7-15 years), ASA I-II, scheduled for tonsillectomy divided into two groups (n = 34) to receive bilateral peritonsillar saline infiltration (placebo group) or peritonsillar saline infiltration in one tonsil (placebo side) and 8 mg lornoxicam in the other tonsil (intervention side; study group). Drugs were administered after induction of anaesthesia and before start of surgery.. Intra-operative and postoperative bleeding score, platelet aggregometry before and 30 min after study drug administration, the verbal rating pain scale, time to first postoperative analgesic request, total analgesic consumption during 1st 24 h postoperative and adverse effects were evaluated.. The difference in bleeding score between groups did not reach our definition of statistical significance (P < 0.05). Platelet aggregometry tests did not change significantly with time between groups. Lower postoperative pain scores, longer time to first analgesic request (372.76 ± 82.15 versus 64.89 ± 25.76 min P < 0.001) and lower paracetamol consumption (421.76 ± 125.63 versus 690.29 ± 141.47 mg, P < 0.001) were recorded in study group compared with control group. No patient required hospital re-admission or re-operation because of postoperative tonsillar bed bleeding.. The lack of significant complications suggests that pre-incisional peritonsillar lornoxicam followed by intravenous paracetamol rescue analgesia may be safe for tonsillectomy in children. To avoid conflict with intra-operative bleeding, postoperative infiltration of lornoxicam is recommended.

Topics: Adolescent; Anti-Inflammatory Agents, Non-Steroidal; Child; Double-Blind Method; Female; Follow-Up Studies; Humans; Injections; Intraoperative Care; Male; Pain Management; Pain Measurement; Pain, Postoperative; Palatine Tonsil; Piroxicam; Prospective Studies; Tonsillectomy; Treatment Outcome

Postoperative pain control constitutes a major problem and studies have focused on reducing opioid requirements using regional techniques. We aimed to investigate the efficacy of wound infiltration with lornoxicam on postoperative pain control following thyroidectomy.. In this prospective, randomized-controlled study, 80 patients scheduled for thyroidectomy were randomly assigned to 2 groups. After the thyroidectomy was performed, patients in group I underwent wound infiltration with 4 mg of lornoxicam and patients in group II received the same amount of saline. Rescue analgesia was provided with additional doses oflornoxicam delivered by an on-demand patient-controlled analgesia device. Total analgesic consumption during the postoperative 24 h, and pain intensities assessed using a visual analog scale score at 0, 2, 4, 8, 12 and 24 h postoperatively were recorded.. Pain scores during the postoperative 24 h were slightly lower in group I than in group II, but the difference was not significant (P > 0.05). The mean analgesic consumption was 8.87 ± 1.87 mg and 10.33 ± 1.25 mg in groups I and II, respectively (P > 0.05).. Wound infiltration with lornoxicam neither improved postoperative pain control nor decreased total analgesic consumption.

Topics: Adult; Analgesia, Patient-Controlled; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Male; Pain Measurement; Pain, Postoperative; Piroxicam; Prospective Studies; Sodium Chloride; Thyroidectomy; Treatment Outcome

Pain is the most encountered complication following third molar surgery. Although nonsteroidal anti-inflammatory drugs are often used for pain control, the effect of preemptive lornoxicam has not been detailed. We compare the analgesic efficacy of preemptive lornoxicam versus postoperative lornoxicam.. Forty-three participants aged 18 to 33 years who had bilateral, symmetrical third molars were included in this double-blind, randomized, placebo-controlled study. All participants took part in each of the 2 groups for a 1-month interval (crossover design). Group Pre received lornoxicam 8 mg intravenously 25 minutes before surgery and 2 mL serum saline postoperatively. Group Post was given the opposite protocol. Pain was evaluated by visual analog scale in the first 12 hours.. We observed statistically significant differences in the reduction of the pain level in group Pre (P < .05). These participants felt less pain in the first 5 postoperative hours and needed fewer analgesics in the first 12 postoperative hours.. Preemptive lornoxicam is effective for postoperative pain control.

Topics: Adolescent; Adult; Analgesia; Anti-Inflammatory Agents, Non-Steroidal; Cross-Over Studies; Double-Blind Method; Female; Humans; Male; Molar, Third; Pain Measurement; Pain, Postoperative; Piroxicam; Tooth Extraction; Tooth, Impacted

Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended for multimodal postoperative pain management. The purpose of this study was to evaluate the postoperative pain relief and opioid-sparing effects of dexketoprofen and lornoxicam after major orthopedic surgery.. After obtaining ethical committee approval and informed consent, 120 patients undergoing elective hip or knee replacement under general anesthesia were randomized to receive two intravenous injections of 50 mg dexketoprofen (GD), 8 mg lornoxicam (GL) or saline as placebo (GP) intravenously. Postoperatively, patient-controlled analgesia (PCA) morphine was started as a 0.01 mg.kg-1 bolus dose, with lockout time of 10 minutes without continuous infusion. Pain assessment was made using the Visual Analogue Scale (VAS) at rest or during movement at postoperative 1, 2, 4, 6, 8, 12, and 24 hours.. The three groups were similar in terms of age, gender, American Society of Anesthesiologists (ASA) class, number of patients who underwent hip or knee surgery, weight, height, and operation duration. Patients in GD and GL demonstrated significantly reduced pain scores at rest and active motion compared to GP, with lower scores in the dexketoprofen group. Patients in GD and GL used significantly less morphine in the postoperative period compared to GP. The total morphine consumption of patients in GD was lower than in GL.. Intravenous application of 50 mg dexketoprofen twice a day and 8 mg lornoxicam twice a day improved analgesia and decreased morphine consumption following major orthopedic surgery. When the two active drugs were compared, it was found that dexketoprofen was superior to lornoxicam in terms of analgesic efficacy and opioid consumption.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Arthroplasty, Replacement, Hip; Double-Blind Method; Female; Humans; Infusions, Intravenous; Ketoprofen; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Perioperative Care; Piroxicam; Prospective Studies; Treatment Outcome; Tromethamine

This study was conducted to compare and evaluate the effect of adding lornoxicam or nitroglycerine as adjuncts to lidocaine in intravenous regional anesthesia (IVRA).. 60 patients were randomly separated into three groups, lidocaine group (group L), lidocaine+lornoxicam group (group LL), and lidocaine+lornoxicam+transdermal nitroglycerine group (group LL-N). Hemodynamic parameters, sensory and motor blocks onset, and recovery times were recorded. Analgesic consumption for tourniquet pain and postoperative period were recorded.. Sensory block onset times and motor block onset times were shorter in the LL-N and LL groups compared with L group. Sensory block recovery time and motor block recovery time were prolonged in the LL and LL-N groups compared with group L. The amount of fentanyl required for tourniquet pain was less in group LL and group LL-N when compared with group L. VAS scores of tourniquet pain were higher in group L compared with the other study groups. Postoperative VAS scores were higher for the first 4 hours in group L compared with the other study groups.. The adjuvant drugs (lornoxicam or TNG) when added to lidocaine in IVRA were effective in improving the overall quality of anesthesia, reducing tourniquet pain, increasing tourniquet tolerance, and improving the postoperative analgesia.

Topics: Administration, Intravenous; Adolescent; Adult; Analgesics; Anesthesia, Conduction; Anesthesia, Intravenous; Blood Pressure; Double-Blind Method; Drug Combinations; Female; Humans; Lidocaine; Male; Middle Aged; Nitroglycerin; Pain Measurement; Pain, Postoperative; Piroxicam; Postoperative Period; Time Factors; Tourniquets; Treatment Outcome; Young Adult

To compare the effects of postoperative patient-controlled intravenous analgesia (PCIA) with morphine, tramadol, or tramadol combined with lornoxicam on serum inflammatory cytokine production.. 60 patients with an American Society of Anesthesiologists (ASA) physical status of I or II, undergoing radical correction of gastric cancer, were equally randomized to receive PCIA with morphine (M group), tramadol (T group), or tramadol combined with lornoxicam (L group). The visual analog scale (VAS) and Bruggemann comfort scale (BCS) scores were used to evaluate the postoperative analgesic efficacy. Serum levels of the interleukins (IL) IL-2, IL-6, and IL-10, and soluble IL-2 receptor (sIL-2R) were measured before anesthesia, 90 min after incision, and 24, 48, and 72 h after surgery.. No significant difference was found in the VAS, BCS, or baseline serum IL-2, IL-6, IL-10, or sIL-2R between the groups. At 90 min after incision, only the IL-6 levels increased (p < 0.05). At 24 h after surgery, the IL-2 levels decreased, with the M group having the lowest levels, while IL-6, IL-10, and sIL-2R levels increased, with the M group having the highest level and the L group having the lowest level (p < 0.05). At 48 h after surgery, the cytokine levels were starting to return to the baselines but still had statistical significance (p < 0.05). At 72 h after surgery, only the IL-6 levels had returned to their baseline.. PCIA using tramadol combined with lornoxicam has less influence on inflammatory cytokines than morphine or tramadol alone in patients undergoing gastric cancer surgery.

Topics: Adult; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Cytokines; Double-Blind Method; Female; Humans; Male; Middle Aged; Pain, Postoperative; Piroxicam; Stomach Neoplasms; Tramadol

To evaluate the non-inferiority of lornoxicam to fentanyl in patient-controlled intravenous analgesia after hysterectomy.. In this prospective randomized controlled study, 117 patients who suffered from moderate to severe pain i.e. pain visual analogue scale (VAS) ≥4 after hysterectomy were allocated to receive lornoxicam (Group L) or fentanyl (Group F) for patient-controlled analgesia. The patients were given a loading dose of lornoxicam 4 mg or fentanyl 50 μg after the enrollment according to the patients' grouping and connected to the patient-controlled analgesia device containing lornoxicam 0.4 g/L or fentanyl 5 mg/L with bolus dose set at 2.5 mL and lockout interval set at 10 min. Pain scores were rated using VAS at 6, 12, and 24 h postoperatively. Pain intensity difference (PID) was the difference between pain scores rated immediately after surgery and 6, 12 and 24 h postoperatively. The sum of pain intensity difference over 24 h (SPID-24) was the sum of PID at 6, 12 and 24 h. non-inferiority could be claimed if the lower limit of the 95% confidence interval (CI) for SPID-24 difference between the two groups was greater than pre-specified non-inferiority margin -3.. No difference was detected for pain scores at any time point between the two groups. SPID-24 were 12.0±6.1 and 10.2±5.4 (P>0.05). SPID-24 difference between the two groups was 0.66, 95%CI -1.24 to 2.56, and the lower limit greater than non-inferiority margin -3. Adverse effects, such as nausea, vomiting, and drowsiness were significantly less in lornoxicam group than in fentanyl group (P<0.05).. Lornoxicam is not inferior to the equivalent dose of fentanyl with regard to the margin pre-specified at -3 in reducing moderate to severe postoperative pain after hysterectomy.

Topics: Adult; Aged; Analgesia, Patient-Controlled; Anti-Inflammatory Agents, Non-Steroidal; Female; Fentanyl; Humans; Hysterectomy; Middle Aged; Pain, Postoperative; Piroxicam; Prospective Studies

To explore the pain control effect of lornoxicam on patients after nasal packing.. A total of 56 patients undergoing nasal packing between January 2011 and August 2011 were randomly divided into the treatment group and control group. (1) Treatment group: routinely given lornoxicam for injection 8 mg(2 ml), intravenous injection, twice a day; (2) CONTROL GROUP: given saline 2 ml, intravenous injection, twice a day, other treatments are the same with the treatment group. Visual analog scale was used to record the painful severity of nose and head at 3, 6, 12, 24 and 48 h,and record the sleep quality score at 24 and 48 h.. The pain in nose and head and night sleeping in treatment group were all significantly better than that in control group.. The analgesic effect of lornoxicam in nasal packing is good, with no evident adverse reactions.

Topics: Adolescent; Adult; Aged; Analgesics; Female; Humans; Male; Middle Aged; Nasal Cavity; Nasal Surgical Procedures; Pain, Postoperative; Piroxicam; Young Adult

The aim of this study was to compare the analgesic effects of intra-articular levobupivacaine alone, intra-articular levobupivacaine in combination with lornoxicam, and intra-articular levobupivacaine in combination with lornoxicam and morphine on patients following arthroscopic surgery.. The study included 60 ASA 1 and 2 patients between the ages of 20 and 70 years, scheduled for elective arthroscopy. Patients were divided into three groups of 20 through a randomized, double-blind method. Group 1 received 50 mg of levobupivacaine intra-articularly, Group 2 received 50 mg of levobupivacaine plus 8 mg of lornoxicam, and Group 3 received 50 mg of levobupivacaine plus 8 mg of lornoxicam and 8 mg of morphine. Visual analog scale (VAS) data was collected prospectively for the first 24 postoperative hours.. Group 2 showed statistically significant differences, especially in VAS values with movement at 0, 4, and 6 hours (p<0.001).. The combination of levobupivacaine and lornoxicam is superior to levobupivacaine alone and the addition of morphine does not improve VAS scores. It appears that the addition of additional drugs for more effective analgesia has its limits.

Topics: Adult; Aged; Analgesics, Opioid; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Arthroscopy; Bupivacaine; Female; Humans; Injections, Intra-Articular; Joint Diseases; Knee Joint; Levobupivacaine; Male; Middle Aged; Morphine; Pain Measurement; Pain, Postoperative; Piroxicam; Young Adult

Shockwave lithotripsy (SWL) is one of the most important treatment modalities for urinary stone disease. The procedure may cause pain, and patient relaxation and cooperation are crucial in maintaining stone localization for optimal fragmentation and patient comfort during the procedure. As yet, there is not a standard analgesic protocol for patients undergoing SWL. We aimed to use three different analgesic agents and compare their efficacy during SWL in this study.. Written informed consents were obtained from 95 patients with kidney stones, and they were randomized to receive lornoxicam (group L, n=32 patients), paracetamol (group P, n=31 patients), and tramadol with a patient-controlled analgesia device (group T, n=32 patients). All groups received patient-controlled analgesia with tramadol during the SWL procedure. The intensity of pain was evaluated with a visual analog scale (VAS).. The mean age of the patients was 41.87 ± 16.53 years, 44.07 ± 11.48 years, and 41.24 ± 14.82 years in group L, group P, and group T, respectively. No significant differences were found between the three groups concerning patient age, stone location, or session duration (P>0.05). The mean VAS scores and analgesic consumption were lower in group L compared with other groups (P<0.05).. The results of this study showed that additional administration of analgesics was decreased with intravenous lornoxicam in comparison with paracetamol and only tramadol.

Topics: Acetaminophen; Adult; Analgesia; Analgesics; Blood Pressure; Female; Heart Rate; Humans; Lithotripsy; Male; Pain Measurement; Pain, Postoperative; Piroxicam; Tramadol

The aim of this prospective, randomized, double-blind study was to determine the more effective supplemental analgesic, paracetamol or lornoxicam, for postoperative pain relief after lower abdominal surgery.. Sixty patients scheduled for lower abdominal surgery under general anesthesia were randomly allocated to receive either isotonic saline (control group), intravenous paracetamol 1 g every 6 h (paracetamol group), or lornoxicam 16 mg then 8 mg after 12 h (lornoxicam group). Additionally pain was treated postoperatively with morphine patient-controlled analgesia. Postoperative pain scores measured by the verbal pain score (VPS), morphine consumption, and the incidence of side effects were measured at 1, 2, 4, 8, 12, and 24 h postoperatively.. Morphine consumption at 12 and 24 h was significantly lower in the lornoxicam group (19.25 ± 5.7 mg and 23.1 ± 6.5 mg) than in the paracetamol group (23.4 ± 6.6 mg and 28.6 ± 7.6 mg). Both treatment groups had less morphine consumption than the control group (28.5 ± 5 mg and 38.1 ± 6.6 mg) at 12 and 24 h, respectively. Additionally, VPS was reduced in the paracetamol and the lornoxicam groups compared with the control group both at rest and on coughing. Further analysis revealed that VPS in the lornoxicam group was significantly lower than that in the paracetamol group only during coughing. Drug-related side effects were comparable in all groups.. Lornoxicam is superior to paracetamol for postoperative analgesia after lower abdominal surgery. However, paracetamol could be an alternative supplemental analgesic whenever an NSAID is unsuitable.. clinicaltrials.gov.identifier:NCT01564680.

Topics: Abdomen; Acetaminophen; Adult; Aged; Analgesia, Patient-Controlled; Analgesics; Digestive System Surgical Procedures; Double-Blind Method; Female; Humans; Male; Middle Aged; Morphine; Pain Measurement; Pain, Postoperative; Piroxicam; Prospective Studies; Urogenital Surgical Procedures

To assess the efficacy of quick-release lornoxicam (LNX) on patient-reported acute pain after dental implant surgery.. The study included subjects in good general health, aged 18 to 65 and scheduled to receive a maximum of three implants in the same quadrant. Participants received either 8 mg LNX or placebo and were asked to use the medications in case of pain in the first 120 min after implant surgery. Assessment of efficacy was performed using self-assessment questionnaires for the evaluation of pain intensity and pain relief for 12 h post dosing. Patients were also asked to record the rescue analgesic number. Evaluation of patient satisfaction was assessed using a 7-point scale. Safety was evaluated by the incidence of adverse events.. A total of 83 (LNX/placebo, 42/41) patients who met the inclusion criteria and finished the evaluation period were included in the study. The proportion of patients experiencing postoperative pain was significantly lower in the LNX-treated group compared to the placebo group. Patients in the LNX group reported significantly higher pain relief scores than the placebo group. Twenty-nine patients in the placebo group and 6 patients in the LNX group used rescue analgesics. The number of used rescue analgesics was 1.024 ± 0.79 and 0.167 ± 0.43 in the placebo and LNX groups, respectively. The level of patient satisfaction was significantly higher in the LNX-treated patients (P = 0.007). No adverse events were reported during the study period.. Quick-release LNX is effective in postoperative acute pain control and has a high safety profile following dental implant surgery.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Chi-Square Distribution; Dental Implantation, Endosseous; Double-Blind Method; Female; Humans; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Patient Satisfaction; Piroxicam; Self Report; Statistics, Nonparametric

This prospective, randomized, double-blind study compared the analgesic efficacy and safety of parecoxib sodium versus lornoxicam and diclofenac, after Lichtenstein tension-free mesh inguinal hernia repair.. Patients were randomly assigned to receive parecoxib 80 mg daily i.v. (Group A), lornoxicam 16 mg daily i.v. (Group B) or diclofenac 150 mg daily i.m. (Group C). Rescue analgesia in all groups consisted of pethidine 25 mg i.m. Pain was measured with an analogue scale (pain intensity score).. Patients treated with parecoxib 80 mg reported significantly lower summed pain intensity scores compared with lornoxicam and diclofenac-treated patients. Duration of analgesia was also significantly longer with parecoxib than with lornoxicam and diclofenac. Adverse events were significantly less common in the parecoxib and lornoxicam group, compared with diclofenac group.. Multiple-day administration of parecoxib 40 mg twice daily is more effective than equivalent doses of lornoxicam and diclofenac, and generally better tolerated than diclofenac after Lichtenstein tension-free mesh inguinal hernia repair.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Cyclooxygenase 2 Inhibitors; Diclofenac; Double-Blind Method; Female; Hernia, Inguinal; Humans; Isoxazoles; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam; Prospective Studies; Surgical Procedures, Operative

The aim of this study is to compare the analgesic efficacy and tolerability of a pre-emptive/post-surgery 4-day regimen of oral ibuprofen 400 mg with that of lornoxicam 8 mg.. Sixteen patients received ibuprofen or lornoxicam, respectively, before and after surgery of impacted third molars in two separate appointments, in a double-blind, randomized, and crossover design. The postoperative analgesic and rescue medication consumption was recorded and pain scores were evaluated with a visual analogue scale at 2, 6, 24, 48, and 72 h, postoperatively.. No statistically significant differences were found between ibuprofen 400 mg and lornoxicam 8 mg with respect to study medication (p = 0.34) or rescue analgesic consumption (p = 0.5) (SUMstudy and SUMrescue). Ibuprofen: SUMstudy median 7.5 interquartile range IQR (4.25-8), 95% CI (4.6-7.7); SUMrescue median and IQR 0, 95% CI (-0.6-4.6). Lornoxicam: SUMstudy median 7 IQR (3.75-9), 95% CI (7.7-4.9); SUMrescue median and IQR 0, 95% CI (-0.7-2.7). The area under the pain intensity curve (AUC(2-72) PI) over the 4 days of investigation did not reveal significant differences between the two medications (p = 0.32). AUC(2-72) PI ibuprofen: median 1,509.7 IQR (712.36-2,444.65); 95% CI (1,078.7-2,156.5). AUC(2-72) PI lornoxicam: median 1,166.9 IQR (783.4-2,221.2), 95% CI (1,032-2,130.6). Moreover, patient satisfaction and incidence of adverse events did not reveal any significant differences between treatment groups.. Ibuprofen 400 mg and lornoxicam 8 mg were rated as equal and effective pain treatment medication after wisdom tooth surgery. In comparison, neither of the drugs provided clinical advantages nor did side effects occur more frequently after one of the analgesics.

Topics: Adolescent; Adult; Anti-Inflammatory Agents, Non-Steroidal; Cross-Over Studies; Double-Blind Method; Female; Humans; Ibuprofen; Male; Molar, Third; Pain Measurement; Pain, Postoperative; Pilot Projects; Piroxicam; Tooth Extraction; Tooth, Impacted; Young Adult

To evaluate the efficacy of preoperative lornoxicam on postoperative pain management following tonsillectomy.. Prospective, randomized, double-blinded, placebo-controlled study.. King Fahd University Hospital.. 40 adult, ASA physical status I and II patients scheduled for tonsillectomy.. Patients were randomly allocated to two groups to receive either intravenous (IV) lornoxicam 16 mg (Group L) or saline as control (Group C) preoperatively. Anesthesia was induced using IV fentanyl and propofol, while endotracheal intubation was facilitated with rocuronium, and maintenance was accomplished using nitrous oxide and sevoflurane.. Pain scores at rest and on swallowing, intraoperative bleeding, interval until first request for rescue diclofenac suppository, and total diclofenac dose given in the first 12 and 24 hours postoperatively were recorded. The frequency of postoperative complications including bleeding, hypoxia, nausea and vomiting also were observed.. Pain scores at rest were significantly lower in Group L than Group C at all observation times. Similarly, pain scores on swallowing were lower in Group L during the first 4 postoperative hours. The maximum verbal pain scale (VPS) in the control group was 7 (5.75 - 8 median, interquartile range) and in the lornoxicam group, it was 4 (4 - 5 median, interquartile range) (P < 0.001). The total diclofenac dose during the immediate postoperative 12 hours was significantly lower in Group L than Group C (65 ± 24 mg vs. 20 ± 25 mg, respectively; P < 0.001). No significant differences were noted for intraoperative bleeding. The frequency of postoperative nausea and vomiting was similar in both groups.. Preoperative 16 mg lornoxicam was effective for immediate postoperative pain relief after tonsillectomy in adults.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Blood Loss, Surgical; Diclofenac; Double-Blind Method; Female; Humans; Injections, Intravenous; Male; Pain Measurement; Pain, Postoperative; Pilot Projects; Piroxicam; Preoperative Care; Prospective Studies; Time Factors; Tonsillectomy; Young Adult

Arthroscopic knee surgery is done in outpatient settings; however, postoperative pain is a major barrier for discharge and limits early rehabilitation. The efficacy of intraarticular application of magnesium sulphate, levobupivacaine and lornoxicam, with placebo on postoperative pain after arthroscopic meniscectomy was evaluated.. One hundred and twenty ASA status I-II patients undergoing elective arthroscopic meniscectomy were included in this randomized, single blind, prospective study. Group-M (GM) patients had intraarticular 500 mg of magnesium sulphate in 20 ml saline; group-P (GP) patients had intraarticular 20 ml saline; group-LB (GLB) patients had 100 mg levobupivacaine in 20 ml (0.5%); group-L (GL) patients had intraarticular 8 mg of lornoxicam in 20 ml saline before tourniquet deflation. Postoperative analgesia was maintained by iv tramadol PCA 0.3 mg kg(-1) bolus dose and 5 min lockout time during the first 4 h and later with paracetamol 500 mg. The NRS values at rest and at exercise and analgesic consumptions were evaluated at the end of the first, second and 4th hours and at the 12th, 24th and 48th hours by an anaesthesiologist who was blind to the solutions administered.. All study groups provided analgesia when compared with GP. The first request of oral analgesic time was shorter in GP. Analgesic consumptions of GP were higher than other groups. Pain scores during 1, 2 and 4 h postoperatively were lower in all study groups than the GP.. Administration of all the drugs provided better analgesia than placebo and the most effective one was lornoxicam.

Topics: Adolescent; Adult; Aged; Analgesics, Opioid; Analysis of Variance; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Arthroscopy; Bupivacaine; Female; Humans; Injections, Intra-Articular; Levobupivacaine; Magnesium Sulfate; Male; Menisci, Tibial; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam; Placebos; Prospective Studies; Single-Blind Method; Statistics, Nonparametric; Tramadol; Treatment Outcome

The aim of this study was to compare the postoperative analgesic effects of preoperative intravenous (i.v.) paracetamol, diclofenac sodium and lornoxicam (nonsteroidal anti-inflammatory drugs).. Sixty patients with impacted third molar who underwent surgical removal were randomly allocated into three groups: group P (n = 20), group D (n = 20) and group L (n = 20). Group P received preoperatively 1 g paracetamol i.v., group D 75 mg diclofenac sodium i.m. and group L 8 mg lornoxicam i.v. Postoperative pain intensity, additional consumption of analgesics postoperatively and postoperative complications were compared among groups.. The groups were comparable for pain scores (p > 0.05). Maximum pain scores were recorded in postoperative 4th h in all groups (group L 22, 14-44 mm; group P 24, 13-43 mm; group D 14, 10-24 mm, p = 0.117). Patients experienced high satisfaction scores which were comparable among groups (group L 85, 75-100 mm; group P 87, 70-95 mm; group D 84, 77-98 mm, p = 0.457).. Preoperative intramuscular diclofenac, intravenous paracetamol and lornoxicam effectively decreased the pain scores. The patients were satisfied with the three postoperative pain management regimens.

Topics: Acetaminophen; Adult; Analgesics, Non-Narcotic; Analysis of Variance; Anti-Inflammatory Agents, Non-Steroidal; Diclofenac; Double-Blind Method; Female; Humans; Male; Molar, Third; Pain Measurement; Pain, Postoperative; Patient Satisfaction; Piroxicam; Premedication; Severity of Illness Index; Statistics, Nonparametric; Time Factors; Tooth, Impacted; Young Adult

Effective pain relief is important after diagnostic and therapeutic arthroscopic knee surgery to permit early discharge and improve comfort and mobility at home. We compared the intraarticular analgesic effects of ropivacaine and morphine with or without Xefocam and the need for rescue i.v. morphine at rest and during movement in patients undergoing anterior cruciate ligament reconstruction under spinal anesthesia. Anterior cruciate ligament reconstruction (ACLR) is associated with moderate to severe postoperative pain.. Forty five patients undergoing anterior cruciate ligament reconstruction (ACLR) under spinal anesthesia were enrolled in this study. Patients were divided into three equal groups (15 each); the C group received saline. The RM group received 0.25% ropivacaine and morphine 0.2 mg/mL; the RMX group received 0.25% ropivacaine, morphine 0.2 mg/mL and Xefocam 0.8 mg/mL postoperatively they received intraarticular patient-controlled analgesia. The study drug was given in a volume of 10-mL bolus and a 60-min lockout interval. If needed, rescue morphine 2 mg was self-administered i.v. with 10-min lockout intervals. Pain scores and patient satisfaction were assessed at rest and during movement. There were significant differences among the groups in pain scores and patient satisfaction and in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Classification. Daily morphine consumption was significantly smaller in the RMX group (7 +/- 6 mg) compared with the RM group (23 +/- 20 mg; P = 0.002) and in both groups compared with control (46 +/- 21 mg; P < 0.001). We conclude that intraarticular patient-controlled regional analgesia provides effective pain relief after anterior cruciate ligament reconstruction. The combination of intraarticular ropivacaine, morphine, and xefocam was superior to control or to a combination of ropivacaine and morphine.

Topics: Adult; Amides; Anterior Cruciate Ligament; Anti-Inflammatory Agents, Non-Steroidal; Arthroscopy; Female; Humans; Injections, Intra-Articular; Male; Morphine; Pain Measurement; Pain, Postoperative; Patient Satisfaction; Piroxicam; Plastic Surgery Procedures; Ropivacaine

The purpose of the present study was to determine the efficacy of intravenous (iv) paracetamol and iv lornoxicam on postoperative analgesia and the reduction in tramadol consumption.. Sixty patients (ASA class 1-2, age: 18-72 years) undergoing thyroidectomy were enrolled in the study, and were randomized into three groups: Group L received 8 mg of iv lornoxicam, Group P received 1 g iv paracetamol and Group C received 100 cc of iv saline solution. All patients received standard general anesthesia. The postoperative salvage analgesic consumption was recorded at 0-6, 6-12 and 12-24 hour (h) intervals. Pain scores were evaluated with a visual analogue scale at 15 min, and 1, 2, 4, 6, 8, 12, 18, and 24 h postoperatively.. The time to first analgesic requirement was approximately 127.5 min in Group L, 162.3 in Group P and 35.5 min in Group C, and the time was found to be significantly prolonged in Group L and Group P. Pain scores were significantly lower in Group P and Group L at 15 min, and 1, 8, 12, and 18 h. Twenty-four hour analgesic consumption was significantly lower in Group P and Group L compared to Group C. Supplemental analgesics requirement was as follows: 100% in Group C, 50% in Group L and 55% in Group P. The degree of satisfaction with postoperative pain management was excellent in 90% in Groups L and P, versus in only 30% in Group C.. Administration of iv lornoxicam and iv paracetamol following thyroid surgery decreased the postoperative pain scores and opioid requirement, as well as the incidence of nausea and vomiting, while also prolonging the time to the first analgesic supplement.

Topics: Acetaminophen; Adolescent; Adult; Aged; Analgesics, Non-Narcotic; Anti-Inflammatory Agents, Non-Steroidal; Female; Humans; Infusions, Intravenous; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam; Thyroidectomy; Treatment Outcome; Young Adult

The combination of opioids with supplemental analgesics is commonly used for additive or synergistic analgesic effects. We aimed to determine the most advantageous supplemental analgesic for postoperative pain relief after lumbar disc surgery.. This prospective, placebo-controlled, randomized, double-blind study compared the effects of intravenous metamizol, paracetamol and lornoxicam on postoperative pain control, morphine consumption and side effects after lumbar disc surgery. Eighty patients with American Society of Anesthesiologists classification 1 or 2 scheduled for elective lumbar disc surgery under general anaesthesia were treated using patient-controlled analgesia with morphine until 24 h postoperatively and randomized to receive additional intravenous injections of metamizol 1 g, paracetamol 1 g, lornoxicam 8 mg or isotonic saline 0.9% (placebo). The primary endpoint was pain over 24 h after surgery measured by visual analogue scale. Secondary endpoints were morphine consumption and side effects.. During the 24 h study period, pain was reduced in the metamizol (P = 0.001) and paracetamol (P = 0.04) groups, but not in the lornoxicam (P = 0.20) group compared with the control group. Further analysis revealed that pain scores in the metamizol group were significantly lower than in the lornoxicam group (P = 0.031). Although the rate of morphine consumption in the paracetamol group was decreased over time (P < 0.001), the total amounts of morphine consumed in 24 h were not different between groups. No significant differences with respect to morphine-related side effects were observed between groups.. Metamizol or paracetamol, but not lornoxicam, provides effective analgesia following lumbar disc surgery.

Topics: Acetaminophen; Adult; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Dipyrone; Double-Blind Method; Female; Humans; Lumbar Vertebrae; Male; Middle Aged; Morphine; Pain Measurement; Pain, Postoperative; Piroxicam; Prospective Studies; Treatment Outcome

Post-marketing surveillance studies can provide supplemental data on the safety of medications in the general population.. This study aimed to evaluate the safety of analgesic regimens including the NSAID lornoxicam in the short-term treatment of postoperative pain in a clinically relevant population.. Randomized, open-label, multicentre, multinational, observational cohort study of 4 days' duration.. In-hospital postoperative setting, with discharge to home treatment within 24 hours of surgery.. Adults aged > or =18 years expected to be in need of analgesic treatment after day-case surgery.. Analgesic regimens containing lornoxicam were compared with a standard analgesic treatment, which was defined as the treatment that the patient would normally receive at the centre.. Following day-case surgery, patients were provided with appropriate analgesic medication, and adverse events (AEs; defined as all recorded events with symptoms) were recorded by the investigator during the in-hospital stay and by the patient for the next 3 days using entries recorded morning and evening in a patient diary. Statistical analyses tested for between-treatment differences in AEs, adverse drug reactions (ADRs; defined as events probably, possibly or unlikely to be related to treatment) and gastrointestinal AEs (GI-AEs).. A total of 4152 patients were randomized to treatment. Since 400 patients did not take any analgesic, the safety population consisted of 1838 patients for lornoxicam and 1914 patients for standard analgesic treatment. Demographic and disease characteristics were similar between the two treatment groups, as were the type of surgery and the anaesthesia used in surgery. In the safety population, 16.9% of patients received no analgesic in hospital, and when analgesics were provided they were often administered in combination. Similarly, approximately 17% of patients did not take any analgesics at home. AEs were reported in 27.1% and 29.4% of patients in the lornoxicam and standard analgesic treatment groups, respectively, and ADRs constituted the majority of these events. No significant differences were demonstrated with regard to the incidence of AEs between the two groups. Most events were of mild or moderate intensity. Consistent with what may be expected for an NSAID, most AEs with lornoxicam were related to the GI system. GI-AEs were reported in 19.5% and 21.3% of patients in the lornoxicam and standard analgesic treatment groups, respectively, and most of these were considered ADRs. Most patients were satisfied with their pain treatment both in hospital and at home.. Lornoxicam-containing regimens are as well tolerated as other analgesic regimens over 4 days in the treatment of postoperative pain.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Ambulatory Surgical Procedures; Anti-Inflammatory Agents, Non-Steroidal; Chi-Square Distribution; Consumer Product Safety; Europe; Female; Humans; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam; Product Surveillance, Postmarketing; Risk Assessment; Time Factors; Treatment Outcome; Young Adult

Intravenous regional anaesthesia (IVRA) is a simple and cost-effective technique that is ideally suited for surgery involving the distal arm. This study compared the effect of lornoxicam or dexmedetomidine in IVRA with prilocaine in patients who underwent hand or forearm surgery. M ethods: This randomized, double-blind study enrolled 75 patients scheduled for hand or forearm surgery. IVRA was achieved with 2% prilocaine 3 mg/kg in the control group (n=25), 2% prilocaine 3 mg/kg plus dexmedetomidine 0.5 microg/kg in the dexmedetomidine group (n=25), and 2% prilocaine 3 mg/kg plus lornoxicam 8 mg in the lornoxicam group (n=25). In all groups, 0.9% NaCl solution was added to make up a total volume of 40 mL. Sensory and motor block onset and recovery times, haemodynamic variables, visual analogue scale (VAS) pain and sedation scores, duration of analgesia, total analgesic consumption over 24 hours, adverse effects and quality of anaesthesia were recorded.. Sensory block onset was shorter and sensory block recovery time longer in the dexmedetomidine group compared with the lornoxicam and control groups (p<0.05). Sensory and motor block recovery times and duration of analgesia for tourniquet were prolonged in the dexmedetomidine and lornoxicam groups compared with the control group (p<0.05). Median VAS scores for tourniquet pain in the dexmedetomidine and lornoxicam groups were lower than that of the control group at 15 and 30 minutes (p<0.05). Postoperatively, the duration of analgesia time was longer and median VAS scores were lower during the first 12 hours in the dexmedetomidine and lornoxicam groups compared with the control group (p<0.05). Total analgesic consumption over 24 hours was lower in the dexmedetomidine and lornoxicam groups compared with the control group (p<0.05). Anaesthesia quality as determined by the anaesthesiologist was better in the dexmedetomidine and lornoxicam group than in the control group (p<0.05).. Addition of dexmedetomidine or lornoxicam to prilocaine in IVRA decreased VAS pain scores, improved anaesthesia quality and decreased analgesic requirement. We suggest that addition of dexmedetomidine or lornoxicam at the doses used in this study to IVRA with prilocaine in this setting can be useful without causing adverse effects. No hypotension, bradycardia or hypoxia requiring treatment was seen in any of the patients. Addition of dexmedetomidine had a more potent effect, shortening sensory block onset time and prolonging sensory block recovery time more than lornoxicam.

Topics: Adult; Analgesics, Non-Narcotic; Anesthesia, Conduction; Anesthesia, Intravenous; Anesthetics, Combined; Anesthetics, Intravenous; Dexmedetomidine; Double-Blind Method; Drug Combinations; Female; Forearm; Hand; Humans; Male; Nerve Block; Orthopedic Procedures; Pain Measurement; Pain, Postoperative; Piroxicam; Prilocaine

In this randomized and prospective study, we compared the analgesic effects of lornoxicam and tramadol in patients after inguinal hernia repair.. A total of 160 patients were assigned in a randomized manner into two groups. Group L received 8 mg lornoxicam i.v. at the end of the operation, followed by 8 mg 12 h after the operation. Group T received 1 mg/kg tramadol at the end of the operation and every 6 h up to 24 h postoperatively. The visual analog scale (VAS) score was assessed at 0, 2, 4, 8, 12, and 24 h after surgery.. All patients completed the study. All vital signs were within normal ranges. The mean VAS score in Group L and in Group T was 21.66 +/- 14.64 and 19.75 +/- 11.82, respectively. No significant differences were found between groups with respect to VAS score. Eight (10%) patients in Group T had nausea.. Lornoxicam 8 mg i.v. and b.i.d., tramadol 1 mg/kg at the end of the surgery and every 6 h up to 24 h after inguinal hernia repair provided rapid and effective analgesia and was well tolerated.

Topics: Adolescent; Adult; Analgesics, Opioid; Analysis of Variance; Chi-Square Distribution; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Female; Follow-Up Studies; Hernia, Inguinal; Humans; Infusions, Intravenous; Male; Pain Measurement; Pain, Postoperative; Patient Satisfaction; Piroxicam; Probability; Prospective Studies; Severity of Illness Index; Tramadol; Treatment Outcome; Young Adult

Topics: Adolescent; Adult; Anti-Inflammatory Agents, Non-Steroidal; Cyclooxygenase Inhibitors; Female; Humans; Ketorolac; Male; Middle Aged; Models, Economic; Neurosurgery; Pain Measurement; Pain, Postoperative; Patient Selection; Piroxicam; Time Factors; Treatment Outcome

The aim of this study was to compare the efficacy of 'scheduled' analgesia with analgesia 'on request in patients after craniotomy.. We performed a prospective randomized study comparing 'scheduled' analgesia with analgesia 'on request' on 126 patients aged 16-70 years undergoing craniotomy for a variety of reasons. Patients were randomized to one of two groups; group 1 (68 patients) received lornoxicam 'on request', and group 2 (58 patients) received 8 mg of lornoxicam preoperatively, immediately after intubation, then 8 mg again 6-8 h after the first injection and 8 mg repeated every 8 h for 48 h postoperatively. Subgroup analysis was performed for patients with supratentorial and infratentorial craniotomy. We measured pain scores (visual analogue scale), mean blood pressure and heart rate at 6, 18, 30, 42 and 54 h after surgery and compared differences in these parameters between groups and amongst subgroups.. Group 1 visual analogue pain scale scores were significantly higher than those in group 2 (P < 0.05). Group 1 patients with infratentorial craniotomy showed higher pain scores than supratentorial craniotomy patients (P < 0.05). No significant differences were observed in mean blood pressure between groups and subgroups (P > 0.05). We found no correlation between visual analogue scale scores, mean blood pressure and heart rate (P > 0.05).. 'Scheduled' analgesia with lornoxicam was more effective for treating post-craniotomy pain than 'on request' analgesia with lornoxicam.

Topics: Adolescent; Adult; Aged; Analgesia, Patient-Controlled; Analgesics, Opioid; Anesthesia; Anti-Inflammatory Agents, Non-Steroidal; Blood Pressure; Craniotomy; Female; Heart Rate; Humans; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam; Tramadol; Young Adult

This study assessed the efficacy and adverse effects of preoperatively administered lornoxicam versus tramadol in adults, for post-tonsillectomy pain.. This prospective, double blind, randomized, clinical research was performed in the Ear, Nose and Throat Surgery Room in the Department of Anesthesia and Reanimation, Gazi University Faculty of Medicine. Forty American Society of Anesthesiologists (ASA) status I-II patients of both gender, aged 18-55 years, were included.. Tonsillectomy patients were divided into two groups: Those in Group L received 8 mg lornoxicam and in Group T received 50 mg tramadol intravenously just before induction of general anesthesia. Induction and maintenance of anesthesia (propofol, atracurium, nitrous oxide and sevoflurane) were standardized. Heart rate and systolic and diastolic arterial pressure data were monitored during the anesthesia. Intra-operative bleeding was scored by the same operator using a 5-point scale at the end of the surgery. Postoperative pain on swallowing was scored by a blinded anesthesiologist using Verbal Rating Scale (VRS) on arrival in the Post Anesthesia Care Unit (T(0)), at 30 min (T(1)), 1h (T(2)), 2h (T(3)), 3h (T(4)), 4h (T(5)), 5h (T(6)), and 6h (T(7)) thereafter. During the first postoperative 6 hours, when VRS >/=2, 1mg.kg(-1) im meperidine was used as a rescue analgesic. Adverse effects in the postoperative 6h period were noted. T(1) and T(2) pain scores in Group T were higher than in Group L (p=0.049, p=0.007, respectively). The number of patients requiring rescue analgesics during the first 6 hours in Group L was lower than in Group T. Nausea-vomiting, bleeding and postoperative hemorrhage values were similar between Group L and Group T.. Preoperative 8 mg lornoxicam was more effective than 50 mg tramadol with respect to early postoperative tonsillectomy pain in adult patients, and side effects were similar.

Topics: Adolescent; Adult; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam; Prospective Studies; Severity of Illness Index; Tonsillectomy; Tramadol; Treatment Outcome; Young Adult

The aim of this study was to evaluate the analgesic efficacy and time to onset of effect of the lornoxicam quick-release (LNX-QR) tablet compared with the standard-release tablet (LNX-ST).. In this randomized, double-blind, single-dose trial, 200 patients with moderate pain after surgical removal of an impacted third molar were randomized to treatment with an LNX-QR 8 mg tablet (80 patients), an LNX-ST 8 mg tablet (80 patients) or placebo (40 patients). Pain intensity (PI) and pain relief (PAR) were assessed (numerical and verbal rating scales) for 6 hours, and time to onset of PAR was recorded. The cumulated sum of PI differences (SPID) and PAR (TOTPAR) were calculated. Tolerability was evaluated by occurrence of adverse events.. Kaplan-Meier analysis of time to onset of analgesic efficacy demonstrated a significantly faster onset with LNX-QR than placebo or LNX-ST (p < 0.0001). Median time of onset was 32 minutes (range 29-37) for LNX-QR and 46 minutes (range 37-59) for LNX-ST. The analgesic efficacy of LNX-QR and LNX-ST were superior to that of placebo, whereas paired comparisons of TOTPAR and SPID showed LNX-QR to be superior to LNX-ST (p < 0.05).. LNX-QR provided a faster onset and superior analgesic effect against pain following third molar surgery than LNX-ST.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Male; Molar; Pain, Postoperative; Piroxicam

N-methyl-D-aspartate receptor antagonists and nonsteroidal anti-inflammatory drugs are believed to prevent opioid-induced hyperalgesia and/or acute opioid tolerance, which could cause an increase in postoperative opioid requirement. In this randomized, double-blind, placebo-controlled study, we investigated whether co-administration of ketamine or lornoxicam and fentanyl could prevent the increase of postoperative morphine requirement induced by fentanyl alone.. Ninety females undergoing total abdominal hysterectomy with spinal anesthesia were randomly assigned to six groups consisting of placebo (normal saline, C), fentanyl (three bolus of 1 microg x kg(-1), F), ketamine (infusion of 15 microg x kg(-1) x min(-1), K), ketamine and fentanyl (infusion of 15 microg x kg(-1) x min(-1) ketamine plus three bolus of 1 microg x kg(-1) fentanyl, FK), lornoxicam (one bolus of 8 mg, L), and lornoxicam and fentanyl (one bolus of 8 mg lornoxicam plus three bolus of 1 microg x kg(-1) fentanyl, FL). Cumulative morphine consumption, pain score, and adverse effects were recorded at 1, 3, 6, 12, 24, and 48 h postoperatively.. Cumulative morphine consumption in Group F was significantly more than that in Group C at 3, 6, and 12 h postoperatively (P < 0.05). Postoperative cumulative morphine consumption was similar in Groups C, K, FK, L, and FL. No differences in postoperative pain scores were observed among groups. More patients in Groups K and FK had hallucinations during and/or after surgery than those in Group C (P < 0.05).. Our data suggest that the increase of postoperative morphine requirements induced by intraoperative administration of fentanyl could be prevented by ketamine or lornoxicam.

Topics: Adult; Analgesics, Opioid; Anesthesia, Spinal; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Excitatory Amino Acid Antagonists; Female; Fentanyl; Humans; Hysterectomy; Ketamine; Middle Aged; Morphine; Pain, Postoperative; Piroxicam; Receptors, N-Methyl-D-Aspartate

Postoperative pain is an important parameter in discharge and rehabilitation in daycase arthroscopic knee surgery. This study compared the efficacy of intraarticular application of lornoxicam, bupivacaine and placebo on postoperative pain after arthroscopic knee surgery. With the approval of the local ethics committee and informed consent of the patients, 90 patients (ASA score I-II), aged between 18-65 years undergoing arthroscopic meniscectomy were included in this randomized, blinded, prospective study and were divided into three groups (30 patients each): 8 mg lornoxicam was applied to Group L (GL), 50 mg bupivacaine to Group B (GB) and normal saline to Group S (GS) in 20 mL volume intraarticularly. Postoperative analgesia was maintained by intravenous tramadol-HCl 50 mg/h at the first 4 h and then paracetamol 500 mg plus codeine 7.5 mg preparation as needed. The numeric rating scale (NRS) values were evaluated at rest and at active-passive motion at 4, 12, 24 and 48 h, total analgesic consumption were recorded. There were statistically significant differences between GS and GL and GS and GB in term of tramadol consumption (p < 0.05 and p < 0.05). The analgesiconsumption of GL patients at the end of 48 h were lower than GB and GS (p < 0.001 and p < 0.05). The NRS values of GL were always lower than the other groups with statistical significance at certain times. We concluded that intraarticular lornoxicam provided better pain control than bupivacaine and saline in arthroscopic knee surgery.

Topics: Adolescent; Adult; Aged; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Arthroscopy; Bupivacaine; Female; Humans; Injections, Intra-Articular; Knee Joint; Male; Middle Aged; Pain, Postoperative; Patient Satisfaction; Piroxicam; Prospective Studies; Range of Motion, Articular; Sodium Chloride; Treatment Outcome; Young Adult

In this study we evaluated the postoperative analgesic efficacy of lornoxicam PO, IM and IV administration preoperatively. Fourty patients, aged between 18-65 years, ASA I-II class, were randomized to four groups. Lornoxicam 8 mg was administired PO, IM, IV (Group PO, Group IM, Group IV) 1 hour before the operation. Analgesia was not performed in control group (Group C). First analgesic requirement time, analgesic consumption and the VAS and VRS pain scores were recorded postoperatively. When VAS 3 patient controlled analgesia with lornoxicam was begun. We found that first analgesic requirement time was shorter, postoperative 2nd hour VAS and VRS scores and drug consumptions were higher in Grup C cases according to the other groups. There was no significant difference in first analgesic requirement time and analgesic consumption. Preoperative administration of 8 mg lornoxicam delayed the first analgesic requirement time and decreased total analgesic requirement. There was no difference on analgesic effect between PO, IM, and IV administrations.

Topics: Administration, Oral; Adolescent; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Drug Administration Routes; Female; Humans; Injections, Intramuscular; Injections, Intravenous; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam; Preoperative Care; Time Factors; Treatment Outcome; Young Adult

We compared the efficacy of intravenous lornoxicam vs. dipyrone in patient-controlled analgesia for postoperative analgesia.. 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.. 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).. Lornoxicam has better tolerability and is a more effective analgesic than dipyrone when administered by patient-controlled analgesia for postoperative analgesia after septorhinoplasty.

Topics: Acute Disease; Adolescent; Adult; Analgesia, Patient-Controlled; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Dipyrone; Double-Blind Method; Elective Surgical Procedures; Female; Humans; Infusions, Intravenous; Male; Meperidine; Middle Aged; Nasal Septum; Pain Measurement; Pain, Postoperative; Piroxicam; Postoperative Nausea and Vomiting; Prospective Studies; Rhinoplasty; Time Factors; Treatment Outcome

In this prospective, randomized study, we evaluate the postoperative analgesic effect of lornoxicam after myomectomy operations.. Forty ASA I-II patients scheduled for myomectomy operation were enrolled to this study. Patients were randomly divided into two groups and epidural block was performed with 0,75 % ropivacaine. After the operation, morphine Patient Controlled Epidural Analgesia (PCEA) combined with placebo (saline 2 ml iv) and morphine PCEA combined with lornoxicam 8 mg iv were administered to patients in Group I and Group II, respectively. Pain was assessed at the 0,1st, 2nd, 4th, 6th, 8th, 12th and 24th hours postoperatively. Chi-square and student's t tests were used for statistical analysis.. VAS( Visual Analog Scale) scores were higher in Group I than Group II at 2nd, 4th, 6th and 24th hours. Total morphine consumption was 10.45+/- 4.03 in Group I and 4.25 +/- 1.74 in Group II.. Single dose iv lornoxicam is a safe and an effective treatment option of post-myomectomy pain as it produces effective analgesia, reduces morphine consumption and does not increase the side effects.

Topics: Amides; Analgesia; Analgesia, Patient-Controlled; Anesthesia, Epidural; Anesthetics, Local; Humans; Morphine; Myoma; Pain Measurement; Pain, Postoperative; Piroxicam; Placebos; Ropivacaine; Time Factors

To compare the metabolic effect of postoperative analgesia with lornoxicam/morphine or morphine on patients undergoing gastrointestinal carcinoma operation.. One hundred patients, undergone gastrointestinal carcinoma operations, were randomly assigned into two groups: group A received postoperative analgesia with lornoxicam/morphine and Group B with morphine alone. Parenteral nutrition with limited nitrogen resource was given to both groups. Visual analog scale (VAS), temperature and postoperative nitrogen balance were monitored postoperatively. The concentration of plasma cortisol , epinephrine, tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) were measured preoperatively and day 1, 3 postoperatively.. VAS of two groups at 24 th, 48 th, 72 th after operation were similar (P>0.05). The temperature of two groups on the third postoperative day increased as compared to that before operation, and the temperature of group B on 1st and 3rd postoperative day [(37.8+/-0.6),(37.5+/-0.8)degrees C] were significantly higher than those of group A[(37.3+/-0.5)degrees C,(37.0+/-0.8)degrees C](P<0.05). Nitrogen balance within 3 days after operation were -7.5+/-3.2, -5.2+/-4.2, -3.1+/-1.2 in group A and -16.7+/-7.3, -10.5+/-6.1, -9.1+/-2.1 in group B (P<0.05). The post-operative plasma concentrations of cortisol and epinephrine increased significantly in both groups as compared to those examined preoperatively(P<0.05), but there was no significant difference between the two groups. However, the plasma concentrations of TNF-alpha and IL-6 in group B were significantly higher than those in group A(P<0.05).. Postoperative analgesia with lornoxicam/morphine or morphine is able to produce an adequate postoperative analgesia to patients undergoing gastrointestinal carcinoma operation. Lornoxicam and morphine analgesia possesses a better metabolic intervention in decreasing the protein metabolism and improving the nitrogen balance.

Topics: Aged; Analgesia; Female; Gastrointestinal Neoplasms; Humans; Hydrocortisone; Interleukin-6; Male; Middle Aged; Morphine; Pain, Postoperative; Piroxicam; Postoperative Period; Tumor Necrosis Factor-alpha

To compare the efficacy of injectable lornoxicam with diclofenac, ketoprofen, and dipyrone for acute postoperative pain.. Prospective, randomized, placebo-controlled, double-blind study.. University hospital.. 200 ASA physical status I patients who were scheduled for elective septoplasty with general anesthesia.. Patients were divided into 5 groups according to the intramuscularly administered analgesic drug: lornoxicam 8 mg (twice daily), diclofenac 75 mg (twice daily), ketoprofen 100 mg (twice daily), dipyrone 1 g (three times daily), and placebo (twice daily).. Pain intensity was evaluated with a 0 to 100 mm Visual Analog Scale (VAS) at the 2nd, 4th, 6th, 8th, 12th, 16th, 20th, and 24th hour postoperatively. Intramuscular pethidine 1 mg/kg was administered to patients requiring additional analgesia, and treatment-related adverse effects were noted.. Pethidine requirement was found to be significantly higher in the placebo group (1.8 mg/kg per 24 hours; 95% confidence interval, 1.5-2.2) than in the other groups (P = 0.001). No significant difference in opioid requirement was found among the treated groups (P > 0.05). Postoperative VAS scores were significantly lower at specific hours in the treatment groups when compared with placebo group (P < 0.05). No statistically significant difference in adverse effects was found among the groups studied (P > 0.05).. Efficacy of lornoxicam in the management of acute postoperative pain was not superior to that of other nonopioid analgesics used in this study.

Topics: Adult; Aged; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Diclofenac; Dipyrone; Double-Blind Method; Female; Humans; Ketoprofen; Male; Meperidine; Middle Aged; Nasal Septum; Pain Measurement; Pain, Postoperative; Piroxicam; Postoperative Nausea and Vomiting; Prospective Studies; Statistics, Nonparametric; Time Factors; Treatment Outcome

The aim of this study was to examine the effect of lornoxicam used in preemptive analgesia on the intensity of pain and requirement for analgesics in the perioperative period for major abdominal surgery.. Sixty patients scheduled for elective major abdominal surgery were randomly assigned to three groups after ethics committee approval. Patients in Group PRE (n=20) received lornoxicam i.v. 8 mg 20 min before incision and saline i.v. after skin closure; patients in Group POST (n=20) received saline i.v. 20 mins before incision and lornoxicam i.v. 8 mg after skin closure; patients in Group C (n=20) received saline i.v. 5 min before incision and after skin closure. A standardized general anesthetic was used. All patients were started on i.v. tramadol patient-controlled analgesia during the postoperative period. Pain intensity was measured using the visual analog scale (VAS), and tramadol consumption. In addition, the incidences of side effects were recorded at the end of the study period.. There were no significant differences among the three groups of the demographic data. Groups PRE and POST demonstrated significantly reduced pain scores compared to Group C at various points in time. Group PRE also demonstrated a weakly significant reduction in analgesic consumption of tramadol postoperatively compared to Groups POST and C.. Lornoxicam administered preemptively appears to improve the quality of postoperative analgesia and leads to reduced consumption of tramadol postoperatively in patients undergoing major abdominal operations.

Topics: Analgesia, Patient-Controlled; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Digestive System Surgical Procedures; Double-Blind Method; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam; Premedication; Tramadol

To investigate whether preemptive administered lornoxicam changes perioperative platelet function during thoracic surgery.. A total of 20 patients scheduled for elective thoracic surgery were randomly assigned to receive either lornoxicam (16 mg, i.v.; n = 10) or placebo (n = 10) preoperatively. All patients underwent treatment of solitary lung metastasis and denied any antiplatelet medication within the past 2 weeks. Blood samples were drawn via an arterial catheter directly into silicone-coated Vacutainer tubes containing 0.5 mL of 0.129 M buffered sodium citrate 3.8% before, 15 min, 4 h and 8 h after the study medication was administered. Platelet aggregation curves were obtained by whole blood electrical impedance aggregometry (Chrono Log).. Platelet aggregation was significantly reduced 15 min, 4 h and 8 h after lornoxicam administration compared to placebo (P < 0.05) for collagen, adenosine diphosphate and arachidonic acid as trigger substances. Adenosine diphosphate-induced platelet aggregation decreased by 85% 15 min after lornoxicam administration, and remained impaired for 8 h.. Platelet aggregation assays are impaired for at least 8 h after lornoxicam application. Therefore perioperative analgesia by use of lornoxicam should be carefully administered under consideration of subsequent platelet dysfunction.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Blood Coagulation Tests; Humans; Lung Diseases; Middle Aged; Pain, Postoperative; Perioperative Care; Piroxicam; Platelet Aggregation; Prospective Studies; Solitary Pulmonary Nodule; Time Factors; Treatment Outcome

The oxicam NSAID lornoxicam is a potent analgesic with excellent anti-inflammatory properties in a range of painful and/or inflammatory conditions, including postoperative pain. Levobupivacaine, the S-(-)-isomer of bupivacaine, is a long-acting local anaesthetic that can be infiltrated into wounds for management of postoperative pain. We assessed the analgesic efficacy of lornoxicam when administered as an adjuvant to levobupivacaine wound infiltration after varicocoele operation.. Sixty patients who underwent varicocoele surgery were randomly assigned to three different treatment groups. Before skin closure, patients received the following treatments: group I (n=20) patients received normal saline 20 mL wound infiltration and intravenous lornoxicam (Xefo, Nycomed Pharma AS, Roskilde, Denmark) 2 mL (8 mg); group II (n=20) patients received 0.25% levobupivacaine (Chirocaine, Abbott Scandinavia AB, Solna, Sweden) 10mL with normal saline 10 mL wound infiltration and intravenous normal saline 2 mL; group III (n=20) patients received 0.25% levobupivacaine 10 mL with normal saline 10 mL wound infiltration and intravenous lornoxicam 2 mL (8 mg). Pain scores and total pethidine (meperidine) consumption were measured at 1, 2, 4, 6, 12 and 24 hours postoperatively. Time to first analgesic requirement and patient satisfaction were also compared post-surgery.. Pain scores during the first 6 hours postoperatively were significantly lower in group III than in group I and group II (p<0.01). Total pethidine consumption was significantly lower in group III (34.0+/-28.0 mg) than in group I (74.0+/-25 mg) and group II (76.0+/-29 mg) [p<0.01]. Time to first analgesic was also significantly longer in group III (14.8+/-8.4 hours) than in group I (6.2+/-5.2 hours) and group II (5.8+/-7.1 hours) [p<0.01]. The incidence of postoperative nausea and vomiting was significantly lower in group III than in group I and group II (p<0.05). More patients in group III described their analgesia as good or excellent than in group I or group II (p<0.01).. In this study, levobupivacaine wound infiltration with adjuvant intravenous lornoxicam administration was associated with better postoperative analgesia during the early postoperative hours after varicocoele surgery than that induced by lornoxicam alone or levobupivacaine wound infiltration alone.

Topics: Adult; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Bupivacaine; Double-Blind Method; Drug Therapy, Combination; Humans; Levobupivacaine; Male; Pain, Postoperative; Piroxicam; Varicocele

Non-steroidal anti-inflammatory drugs are considered as an effective treatment of postoperative pain after laparoscopic cholecystectomy. COX-2 inhibitors are newer drugs having less adverse effects. Data supporting their efficacy postoperatively in comparison to older non-steroidal anti-inflammatory drugs are scarce. Our study is a prospective, randomized, double-blinded, placebo-controlled trial comparing the efficacy of lornoxicam vs. parecoxib for the management of pain after laparoscopic cholecystectomy.. We enrolled 76 patients, ASA I and II, scheduled for elective laparoscopic cholecystectomy. The patients were randomized to receive before induction parecoxib 40 mg i.v., lornoxicam 8 mg i.v. or placebo. Pain at rest and on movement was assessed using a visual analogue scale at 0, 6, 12 h postoperatively. Total meperidine consumption and adverse effects were also recorded.. At 12 h, visual analogue scale scores at rest and on movement were significantly lower with parecoxib and lornoxicam compared with control ( P = 0.047). The percentage of patients needing meperidine and the average dose of meperidine administered was significantly lower with parecoxib and lornoxicam compared with control (P < 0.001 and P = 0.018). There was no difference between parecoxib and lornoxicam. One patient receiving lornoxicam vomited.. Parecoxib 40 mg i.v. and lornoxicam 8 mg i.v. were equianalgesic and both were more efficacious than placebo for the management of pain after laparoscopic cholecystectomy.

Topics: Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Cholecystectomy, Laparoscopic; Cyclooxygenase Inhibitors; Elective Surgical Procedures; Female; Humans; Isoxazoles; Male; Meperidine; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam; Placebos; Prospective Studies; Time Factors; Treatment Outcome

Diflunisal and lornoxicam are currently available non-steroidal anti-inflammatory drugs (NSAIDs) that have been shown to be effective to various degrees in pain relief when administered either pre-emptively or postoperatively. The pre-emptive analgesic efficacy of diflunisal 1000 mg was compared with that of lornoxicam 16 mg in 40 ASA I patients undergoing surgical removal of bilateral impacted third molars. The impacted third molar teeth on one side were removed at the first surgical appointment using one of the two drug regimens being assessed and the teeth on the contralateral side were removed at a second appointment using the alternate drug regimen; all operations were performed by the same surgeon. Acetaminophen up to 2000 mg daily was provided as rescue medication. The postoperative rescue analgesic consumption was recorded and pain scores were evaluated with a visual analogue scale at 2, 4, 6, 12 and 24h postoperatively. No statistically significant differences were found between groups with respect to rescue analgesic consumption and postoperative pain scores. Pre-emptive administration of both NSAIDs proved to be effective in the management of pain following the surgical removal of impacted third molar teeth.

Topics: Adolescent; Adult; Anti-Inflammatory Agents; Cross-Over Studies; Diflunisal; Drug Combinations; Facial Pain; Humans; Middle Aged; Molar, Third; Pain Measurement; Pain, Postoperative; Piroxicam; Preoperative Care; Prospective Studies; Single-Blind Method; Tooth Extraction

The efficacy, tolerability and the morphine-sparing effects of lornoxicam were compared with those of tenoxicam when used preoperatively in patients undergoing laparoscopic cholecystectomy.. In this prospective, double-blind study, 60 ASA I-II patients undergoing laparoscopic cholecystectomy were randomized equally to receive intravenous tenoxicam 40 mg (Group T) or lornoxicam 16 mg (Group L), preemptively. Three patients withdrew from the study, so 57 patients were included in the analysis. In the postoperative period, the first morphine demand times, pain scores, side-effects and cumulative morphine consumptions were evaluated during the first 24 h.. The patient characteristics data and the duration of surgery were similar between two groups, except for body weights (P = 0.002). The first morphine demand time was significantly longer in Group L (P = 0.037), but the pain levels did not differ. The mean pain scores were higher in Group T in the 15 min (P = 0.036), 1 h (P = 0.020), 2 h (P = 0.001) and 4 h (P = 0.0042) after extubation. A statistically significant difference between two groups was found in calculated cumulative morphine consumptions per kilogram in the 15 min (P = 0.037), 30 min (P = 0.016), and 1 h (P = 0.004) and 2 h (P = 0.013) between two groups. There was no difference in the severity of nausea but 13 patients in Group T and five patients in Group L had vomiting (P = 0.018). Patient satisfaction was similar in the two groups.. Preoperatively administered lornoxicam 16 mg significantly prolonged the first morphine demand time, reduced postoperative morphine consumption during the first 4 h and caused significantly fewer adverse effects when compared with tenoxicam after laparoscopic cholecystectomy.

Topics: Adult; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Cholecystectomy, Laparoscopic; Double-Blind Method; Female; Humans; Male; Middle Aged; Morphine; Pain Measurement; Pain, Postoperative; Piroxicam; Prospective Studies; Time Factors

In total knee replacement operation, patients have a severe pain in the postoperative period. Because of side effects of opioids, multiple postoperative pain treatment regimens are more suitable in these elderly patients. In this double-blind, randomized, placebo controlled study, the effect of lornoxicam administration (32 mg/48 hour) on morphine consumption and drug-related side effects were investigated in elderly patients undergoing total knee replacement. Group M (n=23) and Group L (n=23) received morphine with patient controlled analgesia (PCA) device postoperatively. Additionally Group L received lornoxicam 16 mg intravenously 15 minutes before surgery and 8 mg at postoperative 12th and 24th hours. Morphine consumption in Group L were significantly lower than in Group M at 2, 3, 6, 8, 24, 36 and 48th postoperative hours (p<0.05). At the end of 48th hour mean total morphine consumptions (mean+/-SD) for Group M and Group L were 63.70+/-15.70 mg and 34.60+/-16.32 mg, respectively. AUC (area under the curve) Morphine 0-48h in Group M was 59+/-13 and in Group L it was 30+/-13 (p<0.001). Incidence of side effects in Group M were 60% and 25% in Group L (p<0.05). In Group M, 8 patients (40%) experienced nausea and 3 (15%) patients experienced itching where as in Group L, 3 patients (15%) experienced nausea, 1 patient (5%) itching, 1 patient (5%) dry mouth. Lornoxicam administration in total knee replacement is associated with decreased morphine consumption for postoperative analgesia and fewer side effects.

Topics: Aged; Aged, 80 and over; Analgesia, Patient-Controlled; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Arthroplasty, Replacement, Knee; Double-Blind Method; Female; Humans; Infusions, Intravenous; Male; Middle Aged; Morphine; Pain Measurement; Pain, Postoperative; Piroxicam; Treatment Outcome

To determine whether intravenous injection of lornoxicam 30 minutes before skin incision provides better pain relief after varicocelectomy than postoperative administration of lornoxicam.. Prospective, double-blind, randomized clinical investigation.. Operating room and postoperative recovery area.. 44 ASA physical status I and II adult male patients undergoing varicocelectomy.. Patients were randomized either to receive 8 mg lornoxicam infusion 30 minutes before skin incision, followed by saline infusion immediately after skin closure (group 1), or to receive the identical injections but in reverse order (group 2). All patients received local anesthesia with bupivacaine.. Postoperative pain scores were evaluated hourly for the first 8 hours after surgery, then at 12, 16, 20, and 24 hours after surgery, using a 10-cm visual analog scale. Time to first analgesic request and patients' global assessments also were recorded.. Patients in group 1 reported significantly lower pain scores (P < 0.05) at all time intervals except at 24 hours and better global assessment (P = 0.001) than did group 2. There were significantly fewer patients in the preemptive group than group 2 who required rescue analgesic within the first 24 hours (0% vs 22.7%; P = 0.024). Mean time to first analgesic request was also significantly longer in the preemptive group (P = 0.001).. Intravenous lornoxicam administered before surgery has a better analgesic effect for varicocelectomy than when administered postoperatively.

Topics: Adult; Ambulatory Surgical Procedures; Analgesia; Anesthesia, Local; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Humans; Injections, Intravenous; Male; Pain Measurement; Pain, Postoperative; Piroxicam; Postoperative Care; Preoperative Care; Prospective Studies; Sodium Chloride; Time Factors; Treatment Outcome; Varicocele

Comparison of tramadol, tramadol-metamizol and tramadol-lornoxicam administered by intravenous PCA in management of postoperative pain. The aim of the present study was to compare of the postoperative analgesic effects of tramadol, combinations of tramadol-metamizol and tramadol-lornoxicam administered by intravenous Patient Control Analgesia (PCA) in lower abdominal surgery. Sixty adult, female patients who undergoing lower abdominal surgery, were included in this study. Patients were randomized to three groups. The solutions were prepared containing 500 mg tramadol in 50 ml saline (10 mg/ml tramadol) for Group I, 250 mg tramadol+3000 mg metamizol in 50 ml saline (5 mg/ml tramadol+60 mg/ml metamizol) for Group II and 250 mg tramadol+20 mg lornoxicam in 50 ml saline (5mg/ml tramadol + 0.4 mg/ml lornoxicam) for Group III. Loading dose 10 ml was administrated within 30 min 30 to 40 min before the end of the surgery. PCA was started at the first complaint of pain. Pain was evaluated by VAS in every 15 minute intervals at the first hour and later at 2nd, 4th, 8th, 12th, 18th and 24th hours postoperatively. Vital parameters, side-effects, sedation scores and total analgesic consumptions were also recorded concurrently. Total tramadol and anti-emetic consumption, the incidence of postoperative nausea and vomiting (PONV) were significantly higher in group I than the other groups (p<0.05). In conclusion; Tramadol-metamizol and tramadol-lornoxicam combinations administered by intravenous PCA provide efficient postoperative analgesia with less side effects.

Topics: Aged; Analgesia, Patient-Controlled; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Dipyrone; Drug Therapy, Combination; Female; Humans; Infusions, Intravenous; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam; Tramadol; Treatment Outcome

The aim of this study was to compare the effects of lornoxicam and tramadol in patient-controlled analgesia (PCA) after gynecological surgery.. Forty-four patients were randomly allocated to one of two groups after elective gynecological surgery. Patients in group I (n = 22) received IV tramadol, and group II patients (n = 2) received IV lornoxicam with a PCA pump. A visual analogue scale (VAS) (0 = no pain, 10 = worst pain), hemodynamic parameters and side-effects were assessed before starting the infusion (baseline), at the 15th and 30th min, 1st, 2nd, 3rd, 4th, 6th, 8th, 12th, 18th, 24th, 36th and 48th hour thereafter, and results were compared.. Adequate analgesia was achieved in both groups. VAS values in the tramadol group were lower than those of lornoxiacam at the 15th and 30th minute, 1st, 2nd, 4th, 6th, 8th and 12th hour measurements (p < 0.05). Eight patients (36.3%) in group I and six patients (27.2%) in group II suffered from nausea (p > 0.05).. Tramadol and lornoxicam may be used for pain control after gynecological surgery via PCA. However, we conclude that tramadol has better analgesic efficacy than lornoxicam during the first 12 hours postoperatively.

Topics: Analgesia, Patient-Controlled; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Follow-Up Studies; Gynecologic Surgical Procedures; Humans; Middle Aged; Pain Measurement; Pain, Postoperative; Patient Satisfaction; Piroxicam; Probability; Reference Values; Statistics, Nonparametric; Time Factors; Tramadol; Treatment Outcome

Although outpatient knee arthroscopy is probably by far the most frequently performed orthopaedic procedure, there are limited guidelines or consensus concerning the peroral postoperative pain management. A diversity of analgesics both in potency and action is prescribed. The purpose of the present investigation was to grade the pain and need for rescue medication during the first 4 days after the knee arthroscopy, comparing a conventional nonsteroidal anti-inflammatory drug (NSAID) with a selective cox-II-inhibitor (coxib) as postoperative pain medication. One hundred and twenty-two patients scheduled for primary elective knee arthroscopy in general anaesthesia were randomised to either a NSAID (lornoxicam) or a selective cox-II-inhibitor (rofecoxib) postoperatively. Pain ratings and the need for rescue medication were followed for four consecutive days. Side effects were also registered. The need for rescue analgesics was highest the evening after surgery, when 42% of patients required one, or more, oral additional analgesics. The use of rescue medication decreased with time and 30, 25, 16 and 11% of the patients required additional analgesics for day 1 to 4, respectively, still 50% of all patients required at some point one or more rescue analgesics. Overall pain ratings were low, and showed similar pattern with evening and day, 50% of all patients required at some point one or more rescue analgesics. We found, however, no differences in pain ratings, or need for rescue analgesics between the two groups, conventional NSAID and coxib as well as no difference in side-effect profile. In conclusion, patients do require proper pain management also after minor outpatient surgical procedures such as knee arthroscopy. The traditional NSAIDs seem to be the first choice for analgesic and anti-inflammatory effects, when needed after elective arthroscopy of the knee.

Topics: Adolescent; Adult; Aged; Anesthesia, General; Anti-Inflammatory Agents, Non-Steroidal; Arthroscopy; Cyclooxygenase 2 Inhibitors; Female; Follow-Up Studies; Humans; Knee; Lactones; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam; Prospective Studies; Sulfones; Surveys and Questionnaires

The aim of the study was to evaluate the effect of lornoxicam (L) on sensory and motor block onset time, tourniquet pain, and postoperative analgesia, when added to lidocaine in intravenous regional anaesthesia (IVRA).. Forty-five patients undergoing hand surgery were randomly and blindly divided into three groups as to receive either i.v. saline and IVRA with lidocaine 0.5% (Control group, n=15), i.v. saline and IVRA lidocaine 0.5% with lornoxicam (L-IVRA group, n=15), or intravenous lornoxicam and IVRA lidocaine 0.5% (L-IV group, n=15). Sensory and motor blocks onset time, and tourniquet pain was measured after tourniquet application at 5, 10, 20, and 30 min, and analgesic use were recorded during operation. After the tourniquet deflation, at 1, 30 min, and 2, 4 h, visual analogue scales score, the time to first analgesic requirement, total analgesic consumption in first 24 h, and side effects were noted.. Sensory and motor block onset times were shorter and the recovery time prolonged in the Group L-IVRA compared with the other group (P=0.001). A decreased tourniquet pain, a prolonged time first analgesic requirement [229 (85) min vs 28 (20) and 95 (24) min, P=0.0038) and less postoperative analgesic requirements during 24 h were found in Group L-IVRA compared with the other groups (P<0.05).. The addition of lornoxicam to lidocaine for intravenous regional anaesthesia shortens the onset of sensory and motor block, decreases tourniquet pain and improves postoperative analgesia without causing any side effect.

Topics: Adult; Analgesics, Opioid; Anesthesia, Intravenous; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Drug Administration Schedule; Female; Fentanyl; Forearm; Hand; Humans; Lidocaine; Male; Middle Aged; Movement; Pain Measurement; Pain, Postoperative; Piroxicam; Prospective Studies; Sensation; Tourniquets

The purpose of the present study was to determine the postoperative analgesic effects of lornoxicam and the reduction in tramadol consumption. Fourty patients of ASA class I-II, 18-70 years of age, undergoing thyroidectomy were assigned in a randomized manner into two groups: GroupL received 8 mg of lornoxicam i.v. at the end of the operation followed by 8 mg of lornoxicam b.i.d., i.v. for 24 hours postoperatively. GroupP received 4 ml of saline solution i.v. at the end of the operation and the same amount b.i.d., i.v. for 24 hours postoperatively. The requirements for supplemental analgesics were recorded at 0-6, 6-12 and 12-24 hour intervals. Postoperative pain scores were evaluated at 15th min. and 1, 2, 4, 6, 8, 12, 18 and 24th hours using Visual Analogue Scale (VAS). The time to first analgesic requirement was significantly longer in GroupL compared to GroupP (101.7 vs 37.9 min, p<0.001). Pain scores were significantly lower in GroupL compared to GroupP at 15th min, 1, 8 ,12 and 18th hours. Twenty four hour analgesic consumption was significantly lower in GroupL compared to GroupP (p<0.05). The amount of tramadol consumed in GroupL was 60% lower compared to GroupP (100 mg and 250 mg (mean), respectively). 100% of the patients in GroupL and 60 % of the patients in GroupP needed supplemental analgesics. The degree of satisfaction with postoperative pain management was excellent in 95 % of patients in GroupL and 25 % of patients in GroupP. Eighteen patients in GroupP and 9 patients in GroupL had nausea (p=0.002), and fifteen patients in GroupP and 8 patients in GroupL had vomiting (p=0.025). Lornoxicam decreased the opioid need, the incidence of nausea and vomiting and postoperative pain scores. Moreover, it was observed that the time needed for the first analgesic requirement was prolonged following thyroidectomies.

Topics: Adolescent; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Female; Humans; Infusions, Intravenous; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam; Thyroidectomy; Treatment Outcome

To assess the efficacy and safety of lornoxicam, one non-steroidal anti-inflammatory drug (NSAID) in patient-controlled analgesia (PCA) in patients undergoing abdominal surgeries.. Thirty-nine patients scheduled for abdominal surgeries were randomly assigned to different PCA treatment groups using either lornoxicam or fentanyl postoperatively. Pain intensity difference (PID) and sum of pain intensity difference (SPID) were used to assess the analgesic efficacy of both drugs during a 24-hour period.. The analgesic efficacy of lornoxicam is 1/66 of fentanyl, which was shown by SPID value of 3.250 and 3.058, respectively (P > 0.05). Lornoxicam caused fewer adverse events than fentanyl (33% vs. 68%, P < 0.05).. In clinic, we can use lornoxicam to treat postoperative pain effectively and with less adverse reactions compared with fentanyl.

Topics: Adolescent; Adult; Aged; Analgesia, Patient-Controlled; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Cholecystectomy; Double-Blind Method; Female; Fentanyl; Humans; Hysterectomy; Laparoscopy; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam

Topics: Analgesics, Opioid; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Cholecystectomy, Laparoscopic; Cholecystitis; Cholecystitis, Acute; Cholelithiasis; Drug Therapy, Combination; Humans; Injections, Intramuscular; Pain, Postoperative; Piroxicam; Postoperative Complications; Procaine; Promedol

To compare efficacy and patient outcome of wound infiltration with ropivacaine, lornoxicam, or their combination for control of pain following thyroid surgery.. Eighty patients underwent thyroid surgery were randomly assigned to one of four groups. Before skin closure, local tissues were infiltrated with 12 mL saline in Group S, with 10 mL of ropivacaine 0.75% plus 2 mL saline in Group R, with 2 mL of lornoxicam (8 mg) plus 10 mL saline in Group L, and with 10 mL ropivacaine 0.75% plus 2 mL lornoxicam (8 mg) in Group RL. Pain scores, total and incremental meperidine con-eight, 12, 18, and 24 hr postoperatively. Time to first analgesic requirement, patient satisfaction, and duration of hospital stay were also compared after surgery.. The pain scores in Group RL were significantly lower in the first 12 hr than in Group S, and in the first four hours than in Groups R and L (P < 0.01). The time to first analgesic requirement was significantly longer (14.8 +/- 8.4 hr vs 5.9 +/- 5.2 hr; P < 0.01), the total pethidine consumption was significantly less than Group S (34.0 +/- 33.0 mg vs 78.0 +/- 29.8 mg; P<0.001), return of gastrointestinal function, ambulation time, length of hospital stay (P < 0.05) were significantly shorter, and patient satisfaction (P < 0.01) was significantly better in Group RL than in Group S (P < 0.05).. Wound infiltration with ropivacaine 0.75% plus lornoxicam 8 mg combination improved postoperative pain control and patient comfort, and decreased the need for opioids than the use of either drug alone.

Topics: Adult; Aged; Amides; Analgesics, Opioid; Anesthesia, Local; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Patient Satisfaction; Piroxicam; Postoperative Complications; Prospective Studies; Ropivacaine; Thyroidectomy; Treatment Outcome

Lornoxicam has been used in microsurgical lumbar discectomy. However, there is no data about controlling pain after open discectomy or laminectomy.. To compare the efficacy of a single dose of 16 mg of lornoxicam for the treatment of pain after disectomy or laminectomy with placebo in the PACU.. Randomized, double blind, placebo-controlled trial.. Fifty-six patients who underwent discectomy or laminectomy were randomly allocated to receive 16 mg lornoxicam (Group L), or placebo (Group P) at the beginning of wound closure. Pain scores at rest (using a verbal numeric rating scale: VNRS 0-10), time to first analgesia requirement, morphine consumption during the first 2 hr after surgery and adverse effects were all recorded. The outcomes were assessed on admission to the PACU (T0), then at 1 (T1) and 2 (T2) hr after surgery.. Baseline data were comparable between the two groups. The proportion of patients with VNRS > 5 at T0 in both groups were not significantly different (44.4% in group P vs 50.0% in group L, CI of difference: - 32.4%, 21.3%, p = 0.68). The mean VNRS scores, at T0 and T1 were > 5 and at T2 was < 5 in both groups. There was no difference between the two groups. The morphine consumption in both groups was not different (9.0 mg vs 9.3 mg) as well as the time to first analgesia requirement (35 min vs 40 min). Patients in the two groups had no significant difference in the symptoms or degree of nausea/vomiting. The number of patients with excessive sedation and the proportion of patients needing oxygen during transportation to the ward were not different.. Lornoxicam 16 mg given intravenously before wound closure provides inadequate pain relief immediately after disectomy or laminectomy in the PACU. However, adequate pain relief was demonstrated at 2 hr after surgery, which was similar to the placebo.

Topics: Adolescent; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Diskectomy; Double-Blind Method; Humans; Laminectomy; Lumbar Vertebrae; Middle Aged; Pain, Postoperative; Piroxicam

Lornoxicam is a non opioid analgesic belonging to the oxicam group. The aim of this study was to determine whether lornoxicam has a preemptive analgesic effect.. This study was carried out in a randomized, double-blind fashion with 66 patients divided into three groups undergoing gynecological operations. Group I was administered 8 mg of lornoxicam i.v. preoperatively followed by an 8-mg bolus every 8 h for a total dose of 24 mg in the first 24 h. Group II was administered 8 mg of lornoxicam i.v. bolus before the end of the operation followed by 8 mg every 8 h for a total dose of 24 mg in the first 24 h. Group III was administered placebo before and after the operation and for the first 24 h. The effectiveness was assessed postoperatively using the visual analogue scale (at rest, on exertion) and by calculating the total analgesic consumption of morphine hydrochloride in the first 24 h following operation. Vital signs and side effects were documented.. Groups I and II demonstrated significantly reduced pain scores compared to group III at various points in time. Group I also demonstrated a weakly significant reduction in analgesic consumption of morphine hydrochloride postoperatively compared to groups II and III.. Lornoxicam administered preemptively appears to improve the quality of postoperative analgesia and lead to reduced consumption of opioid analgesics postoperatively in patients undergoing gynecological operations.

Topics: Adult; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Drug Administration Schedule; Female; Genital Diseases, Female; Genital Neoplasms, Female; Humans; Injections, Intravenous; Middle Aged; Morphine; Pain Measurement; Pain, Postoperative; Piroxicam; Postoperative Period; Preoperative Care; Time Factors

To investigate the effectiveness of intravenous lornoxicam and morphine with the preemptive effects of ropivacaine local skin infiltration and peritoneal instillation in reducing postoperative pain after transabdominal hysterectomy, a randomized, double blinded, placebo-controlled study was done in 88 patients undergoing transabdominal hysterectomy under general anesthesia. The patients were allocated into 4 groups to receive: (group A) only intravenous morphine 10 mg; (group B) intravenous morphine 10 mg and lornoxicam 16 mg; (group C) intravenous morphine 10 mg, lornoxicam 16 mg with 0.5 per cent ropivacaine local skin infiltration before skin incision and 1 per cent ropivacaine instillation before peritoneal incision; (group D) intravenous morphine 10 mg, lornoxicam 16 mg with 1 per cent ropivacaine instillation after peritoneal closure and 0.5 per cent ropivacaine local skin infiltration before skin closure. Pain was assessed by patients using visual analog scales (VAS) at 2, 6, 12, 18, 24, 48 hours after surgery. Time to first analgesic requirement and morphine requirement during the first 6 h were significantly lower in the groups using lornoxicam (group B, C, D) as compared with the group using only morphine (group A). However there was no significant difference between group B and group C or group D which means that the additional analgesic effects of using local anesthetic infiltration and instillation either before (pre-emptive) or after the incision could not be seen in this study.. Intravenous 16 mg of lornoxicam with 10 mg of morphine significantly reduced postoperative pain during the first 6 h after abdominal hysterectomy. Additional effects of using local anesthetic wound infiltration to the use of lornoxicam could not be demonstrated.

Topics: Adult; Aged; Amides; Analgesics, Opioid; Analysis of Variance; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Chi-Square Distribution; Double-Blind Method; Female; Humans; Hysterectomy; Injections, Intraperitoneal; Injections, Intravenous; Middle Aged; Morphine; Pain Measurement; Pain, Postoperative; Piroxicam; Ropivacaine; Statistics, Nonparametric; Treatment Outcome

This randomized double-blind study compared the analgesic efficacy and tolerability of intramuscular lornoxicam and tramadol in 76 patients with moderate to unbearable pain following arthroscopic reconstruction of the anterior cruciate ligament using the patella bone-tendon-bone technique. Patients receiving a single dose of lornoxicam 16 mg experienced significantly greater total pain relief than patients receiving tramadol 100 mg over the following 8 hours. Lornoxicam had greater analgesic efficacy than tramadol in patients with moderate baseline pain but was of equivalent efficacy in those with severe/unbearable baseline pain. Fewer patients in the lornoxicam group required rescue medication (58% vs. 77%, respectively). Patients' global impression of efficacy showed lornoxicam to be superior to tramadol with 82% and 49% of patients, respectively, rating treatment as good, very good, or excellent. Following multiple-dose administration of lornoxicam (8 mg tid) or tramadol (100 mg tid) for 3 days, efficacy profiles similar to those following a single dose were obtained. Thus, slightly fewer patients in the lornoxicam group required rescue medication, and patients' global impression of efficacy again favored lornoxicam. Adverse events were reported by 38 of the 76 patients and were mainly mild to moderate in severity. Significantly fewer patients reported one or more adverse events with lornoxicam than with tramadol (14 vs. 24, respectively). Thus, intramuscular lornoxicam offers a useful alternative to tramadol for the treatment of moderate to severe postoperative pain.

Topics: Adolescent; Adult; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Dizziness; Double-Blind Method; Fatigue; Female; Headache; Humans; Male; Middle Aged; Nausea; Pain, Postoperative; Piroxicam; Severity of Illness Index; Tramadol; Treatment Outcome; Vomiting

The analgesic efficacy and tolerability of lornoxicam (Xefo; Nycomed Pharma A/S, Roskilde, Denmark), a new nonsteroidal antiinflammatory drug, was compared with that of morphine in a double-blind, randomized, parallel-group study of 96 patients with at least moderate pain after lumbar microsurgical discectomy. Both drugs were administered i.v. via a patient-controlled analgesia (PCA) for up to 24 h postoperatively. Efficacy was assessed by comparing mean hourly pain intensity differences, mean hourly pain relief, and total pain relief (TOTPAR) values derived from a 5-point verbal rating scores of pain intensity and pain relief at several time points over 24 h. Of 79 patients included in a per-protocol analysis, statistically significant equivalence of lornoxicam and morphine was shown by TOTPAR values of 31.6 and 28.9, respectively (P = 0.048). Trends toward slightly faster onset of analgesia with morphine and slightly greater PCA demands with lornoxicam were observed initially, which may partly have been due to a higher baseline pain intensity in the lornoxicam group. Lornoxicam caused fewer adverse events than morphine (21.7% vs 38.0% of patients, respectively), most of which were mild or moderate in severity. These results suggest that lornoxicam is an alternative to morphine when administered by PCA for the treatment of moderate to severe postoperative pain.. After surgery for lumbar disk disease, patients obtained statistically equivalent pain relief with lornoxicam and morphine when administered by patient-controlled analgesia. However, lornoxicam was associated with a lower incidence of adverse events. This study suggests that lornoxicam provides an alternative to morphine for the treatment of postoperative pain.

Topics: Adolescent; Adult; Aged; Analgesia, Patient-Controlled; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Intervertebral Disc; Laminectomy; Lumbosacral Region; Male; Middle Aged; Morphine; Pain, Postoperative; Piroxicam

This 24-hour, randomised, double-blind, placebo-controlled study compared the efficacy and tolerability of intravenous injections of lornoxicam 4 mg and 8 mg with tramadol 50 mg in 78 female patients aged 20-65 years with moderate to intolerable postoperative pain following mainly hysterectomy. Patients who received lornoxicam 8 mg had a significantly (p < 0.05) longer time to first remedication than placebo recipients and tended to have a greater reduction in pain intensity and a longer time to withdrawal due to "non-response' than tramadol and placebo patients. Lornoxicam was well tolerated at both doses and was associated with a lower incidence of adverse events than tramadol. Thus, intravenous lornoxicam at a dose of 8 mg is superior to placebo and at least as effective as intravenous tramadol 50 mg in relieving moderate to intolerable post-hysterectomy pain. Furthermore, lornoxicam seems to possess a more favourable tolerability profile than tramadol.

Topics: Adult; Aged; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Hysterectomy; Middle Aged; Pain, Postoperative; Piroxicam; Tramadol

The aim of the present study was to investigate the dose-effect relationship of single doses of 4 to 32 mg of lornoxicam (LNX), a new nonsteroidal antiinflammatory drug belonging to the oxicam group, compared with placebo and 10 mg ketorolac (KET) in the treatment of pain after oral surgery. Also, it was the aim of the study to evaluate the relationship between adverse events and different doses of LNX. After the surgical removal of a mandibular third molar, test medication was taken when the patients experienced at least moderate pain. After medication, pain relief, pain intensity, and any discomfort from the medication were noted in a questionnaire. Paracetamol was used as rescue medication. A total of 278 patients completed the study according to the protocol. The primary efficacy parameter was total pain relief after 6 hours, and all active treatments showed significantly better effect than placebo, with LNX 16 and 32 mg being significantly superior to LNX 4 mg. All other efficacy parameters showed the same dose-effect relationship. A total of 37 adverse events were reported evenly distributed in the 6 treatment groups; only 3 of these were considered severe, and all disappeared without treatment. In conclusion, the study showed a dose-effect relationship of LNX without a rise in adverse events. The effect of 10 mg KET seemed to be at the level of 8 to 16 mg LNX.

Topics: Adolescent; Adult; Analgesics, Non-Narcotic; Anti-Inflammatory Agents, Non-Steroidal; Dose-Response Relationship, Drug; Double-Blind Method; Humans; Ketorolac; Mandible; Molar, Third; Pain, Postoperative; Piroxicam; Tolmetin; Tooth Extraction

The pain experienced after third molar surgery was used as a model to evaluate the analgesic efficacy of a new non-steroidal anti-inflammatory drug, lornoxicam, in a Phase II study. One hundred and fifty fit, young adults participated in this randomised, single dose, double-blind, parallel group clinical study. Three doses of lornoxicam (2 mg, 4 mg, and 8 mg) were compared with aspirin 650 mg and placebo. Patients suffering from moderate to severe pain following surgery were monitored for up to 8 hours. All indices of efficacy showed similar results, all active treatments being associated with highly significant (P less than 0.0001) reductions in pain during the study period. Lornoxicam 8 mg demonstrated significant analgesic efficacy as compared with placebo. The two lower doses of lornoxicam and aspirin all showed apparent degrees of efficacy intermediate between that of placebo and lornoxicam 8 mg, although the trial proved to have inadequate power to show significant differences between these three treatments. Lornoxicam was very well tolerated at all three doses studied, with no adverse events definitely attributable to its administration.

Topics: Adolescent; Adult; Analysis of Variance; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Chi-Square Distribution; Double-Blind Method; Female; Humans; Male; Middle Aged; Molar, Third; Pain Measurement; Pain, Postoperative; Piroxicam; Tooth Extraction

To determine efficacy and safety of patient-controlled intravenous analgesia (PCIA) with tramadol and lornoxicam for postoperative analgesia, and its effects on surgical outcomes in patients following thoracotomy.The records of patients who underwent thoracotomy for lung resection between January 2014 and December 2014 at our institution were reviewed. The patients were divided into 2 groups according to postoperative pain treatment modalities. Patients of the patient-controlled epidural analgesia (PCEA) group (n = 63), received PCEA with 0.2% ropivacaine plus 0.5 μg/mL sufentanil, while patients in the PCIA group (n = 48), received PCIA with 5 mg/mL tramadol and 0.4 mg/mL lornoxicam. Data were collected for the quality of pain control, incidences of analgesia related side effects and pulmonary complications, lengths of thoracic intensive care unit stay and postoperative hospital stay, and in-hospital mortality.Pain at rest was always controlled well in both groups during the 4-day postoperative period. Patients in the PCIA group reported significantly higher pain scores on coughing and during mobilization in the first 2 postoperative days. The incidences of side effects and pulmonary complications, in-hospital mortality and other outcomes were similar between groups.PCIA with tramadol and lornoxicam can be considered as a safe and effective alternative with respect to pain control and postoperative outcomes for patients underwent thoracotomy.

Topics: Adult; Age Factors; Aged; Analgesia, Epidural; Analgesia, Patient-Controlled; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Female; Hospital Mortality; Humans; Length of Stay; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam; Postoperative Complications; Respiratory Function Tests; Ropivacaine; Sex Factors; Sufentanil; Thoracotomy; Tramadol

Formulation of injectable In situ forming implant (ISI) systems of lornoxicam for dental and postoperative pain management to decrease dosing frequency and increase patient compliance.. Polymeric in situ implant solutions were prepared using different concentrations and inherent viscosities of Poly-DL-lactide (PDL) or DL-lactide/glycolide copolymer (PDLG) using 22X4 factorial experimental design. Nonpolymeric systems were prepared using different concentrations of lipids like cetyl alcohol and stearyl alcohol and also sucrose acetate isobutyrate (SAIB) using 32 factorial experimental design. In vitro release study, rheological measurement, syringeability assessment and effect of γ-sterilization were used for evaluation of the prepared formulae. In vivo pharmacokinetic study of lornoxicam from the most optimum formula was conducted in a rabbit model using HPLC analysis of blood samples.. Polymeric systems showed high burst release followed by very slow release rate over 72 hours. Formula I 24 (containing SAIB 80% (w/w)) showed relatively low burst release followed by diffusion controlled release pattern, low viscosity, Newtonian flow behavior and good syringeability. γ- sterilization had no significant effect on the in vitro release and the physical nature of the most optimum formula. In vivo study concluded that intramuscularly injected In situ implant formula I 24 showed prolonged release pattern compared to the marketed product which was indicated by the increased Tmax and the extended mean residence time.. Lornoxicam ISI systems could be promising as convenient injectable sustained release delivery systems for dental and postoperative pain management.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Drug Implants; Drug Liberation; Fatty Alcohols; Injections; Male; Pain, Postoperative; Piroxicam; Polyesters; Polyglycolic Acid; Rabbits; Viscosity

Acute hind limb ischemia reperfusion (I/R) injury is a common consequence of abdominal aorta cross‑clamping during aortic surgery. Erythrocyte deformability is affected by I/R process and may lead to increased tissue and organ injury. Lornoxicam and intravenous ibuprofen are becoming commonly used as non-steroidal anti-inflammatory drugs (NSAID) for postoperative analgesia. In this study, we aimed to investigate the effects of lornoxicam (2 mg/kg iv) and intravenous ibuprofen (30 mg/kg iv) on erythrocyte deformability in I/R model in rats.. Four study groups, each containing 6 Wistar rats were created. Laparotomy was performed in all groups under general anesthesia with ketamine and xylazine. In all groups except sham group, ischemia and reperfusion were achieved by clamping and declamping the infrarenal abdominal aorta for 120 minutes. Rats in Group IR+L received intravenous infusion of lornoxicam (2 mg/kg) while rats in Group IR+I received intravenous infusion of ibubrofen (30 mg/kg) following 2 hours of ischemic period. At the end of reperfusion period, erythrocyte packs were prepared from heparinized blood samples. Erythrocyte suspensions with hematocrit at a concentration of 5% in a phosphate‑buffered saline (PBS) were used in order to perform deformability measurements. The value of p<0.05 was considered statistically significant.. Relative resistance has increased in ischemia reperfusion group when compared to control group (p < 0.0001). Lornoxicam or ibuprofen intravenous treatments did not change the erythrocyte deformability during ischemia reperfusion period in rats (p=0.851, p=0.690).. Intravenous ibuprofen or lornoxicam administrations during ischemia reperfusion period in rats have no negative effect on erythrocyte deformability. The findings of the study should be supported with more detailed and extensive clinical/experimental studies in the future (Fig. 1, Ref. 18).

Topics: Administration, Intravenous; Analgesia; Animals; Anti-Inflammatory Agents, Non-Steroidal; Erythrocyte Deformability; Erythrocytes; Hindlimb; Ibuprofen; Infusions, Intravenous; Ischemia; Male; Pain, Postoperative; Piroxicam; Rats; Rats, Wistar; Reperfusion Injury

Data of 53 patients, operated on infrarenal aorta and large vessels were analyzed. Different combinations of nonopioid drugs were compared, used postoperatively. These were: ketoprofen+tramadol; lornoxicam+tramadol; paracetamol+tramadol; paracetamol+lornoxicam+tramadol. All of the combinations provided good analgesic effect. Inclusion of paracetamol allowed faster pain relief and decrease of tramadol intake. In patients with an increased ulcer risk, postoperative analgesia should be based on paracetamol and tramadol.

Topics: Acetaminophen; Adult; Aged; Analgesia; Analgesics, Non-Narcotic; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Aorta, Abdominal; Blood Vessel Prosthesis; Drug Therapy, Combination; Female; Humans; Ketoprofen; Male; Middle Aged; Pain, Postoperative; Piroxicam; Tramadol

To compare the analgesic efficiency and adverse effects of postoperative patient-controlled intravenous analgesia (PCIA) with lornoxicam and sufentanil in patients undergoing oral maxillofacial surgery.. 200 ASA (American Society of Anesthesiologists) I-II patients who undertook oral maxillofacial operation were divided into two groups: lornoxicam group (group L) and sufentanil group (group S), with 100 patients in each group. The effectiveness was assessed with visual analogue scale (VAS), Prince-Henry score (PHS) and Ramsay sedation Score (RSS) at different time points: 4, 8, 12, 24 and 48 h after the beginning of analgesia. The analgesic efficacy of analgesia and the adverse effects during analgesia period were observed.. Statistical analysis revealed no significant difference in VAS, PHS and RSS at 4, 8, 12, 24, 48 h and the overall satisfaction on analgesia therapy. The percentage of nausea, vomiting and dizziness was significantly lower in group L than that in group S (1% vs 9%, 0 vs 4%, 0 vs 3%, P<0.05).. Lornoxicam could provide an identical efficacy as sufentanil in the postoperative PCIA in patients undergoing oral maxillofacial surgery. In addition, lornoxicam caused less adverse effects.

Topics: Adolescent; Adult; Aged; Analgesia, Patient-Controlled; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Female; Humans; Injections, Intravenous; Male; Middle Aged; Pain, Postoperative; Piroxicam; Sufentanil; Surgery, Oral; Young Adult

Intraarticular (i.a) drug application is consider to be a new therapeutic approach for the treatment of postoperative pain after arthroscopic knee surgery without any systemic adverse effects. Lornoxicam, a nonsteroid anti-inflammatory drug is a short acting agent, and its anti-inflammatory and analgesic activity may be effective in the postoperative pain management in minor surgery. In this study, the effects of intraarticular administration of lornoxicam on the synovium and articular cartilage in the rat knee joint were investigated.. Lornoxicam (0.25 ml) was given as an injection into the right knee joint and 0.25 ml of 0.9 per cent saline solution by injection into the left knee joint as a control in 25 rats. Groups of five rats were sacrificed by a lethal injection of ketamine 1st, 2nd, 7th, 14th and 21st days after lornoxicam administration. Knee joints were detached, fixed in 10 per cent buffered formalin and decalcified. Serial sections of 5 microm were stained with haematoxylin-eosin and evaluated for the presence of inflammation in the articular, periarticular regions and synovium. Inflammatory changes in the joints were graded according to a five-point scale, histologically.. There were no significant differences in inflammation and cartilage degeneration, between control and lornoxicam applied knees. Grade 3 inflammatory changes occurred only in one knee in lornoxicam group, at 24 h after injection. No pathological changes were observed in both groups at any time point.. Lornoxicam did not show significant effect on inflammation on rat synovia in knee joint. Further studies including in human need to be done before any recommendations are made for i.a. administration of lornoxicam.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Cartilage, Articular; Injections, Intra-Articular; Knee Joint; Pain, Postoperative; Piroxicam; Rats; Rats, Sprague-Dawley; Synovial Membrane

We aimed to determine the analgesic efficacy and clinical or histopathological neurotoxicity of epidural single-dose lornoxicam. Caudal epidural catheters were inserted into 28 rabbits, divided into four groups, on day 1. Pain latency and degree of motor and sensory loss for each animal for different concentrations of lornoxicam were determined on day 2. All animals were sacrificed on day 3 and laminectomy was performed. Five-mum thick sections of spinal cord, obtained from two segments caudal and two segments rostral from tip of the catheter, were fixed and were stained and evaluated by light microscopy. Lornoxicam produced dose-dependent analgesia (increase in pain latency), brief, mild and reversible motor and sensory block, and histopathological signs of neurotoxicity. Clinical application of epidural lornoxicam should proceed with caution.

Topics: Analgesia, Epidural; Anesthesia, Spinal; Animals; Anti-Inflammatory Agents, Non-Steroidal; Catheterization; Dose-Response Relationship, Drug; Dyskinesia, Drug-Induced; Pain; Pain Measurement; Pain Threshold; Pain, Postoperative; Piroxicam; Rabbits; Reaction Time; Sensation Disorders; Spinal Cord

To compare quality of anesthesia with opioid drug and nonsteroid anti-inflammatory drugs in 123 patients after extensive operative interventions of the lungs and trachea, abdominal organs, lower limbs.. Patients of group 1 took lornoxicam for relief of postoperative pain syndrome, those of group 2--promedol. Quality of anesthesia was assessed by visual-analogue and verbal scales, day dose of analgetic drug, administration of promedol, side effects incidence.. Lornoxicam in a dose 8 mg intravenously has comparable with 20 mg promedol analgetic effect. This justifies its use as a basic analgetic for treatment of acute pain after extensive surgery. Lornoxicam allows surgeons to do without opioids in 10-45% patients or to reduce their dose by 32-65%.. Adequate anesthesia with lornoxicam and promedol early after surgery on the chest and abdominal organs, major vessels of the lower limbs occurs in 82 and 87% patients, respectively. Lornoxicam administration as continuous intravenous infusion and controlled analgesia in older patients eliminates the need in opioid analgetics in 45% cases and is well tolerated.

Topics: Aged; Aged, 80 and over; Analgesia; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Dose-Response Relationship, Drug; Follow-Up Studies; Humans; Injections, Intravenous; Pain Measurement; Pain, Postoperative; Piroxicam; Postoperative Care; Postoperative Period; Promedol; Treatment Outcome