lornoxicam and Postoperative-Complications

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

Total abdominal hysterectomy (TAH) is most commonly performed for benign lesions and malignant diseases of the uterus. Postoperative immuno-suppression caused by TAH has become a serious clinical problem, due to the high incidence of infectious complications after this operation. Lornoxicam (LOR) is a member of non-steroidal anti-inflammatory drugs and a cyclooxygenase inhibitor. In this study, 45 patients undergoing TAH for uterine myoma were enrolled and given intravenous injection of normal saline (untreated patients) or LOR (8 or 16 mg) preoperatively (15 patients/group). We studied the effects of LOR on postoperative immuno-suppression by determining the serum levels of three cytokines, RANTES, monocyte chemotactic protein-1 (MCP-1), and stromal cell-derived factor 1alpha (SDF-1alpha). MCP-1 and RANTES are involved in the pathophysiology of acute and chronic inflammatory processes, and SDF-1alpha is considered as an inflammatory chemoattractant. Following TAH, the serum levels of RANTES were reduced in the untreated patients, but were significantly higher in the patients treated with LOR. In addition, the levels of MCP-1 and SDF-1alpha were significantly elevated in the untreated patients, but were significantly lower in the patients treated with LOR. Furthermore, preoperative treatment with LOR 16 mg could regulate the serum levels of these three chemokines more effectively, compared to that with LOR 8 mg. In conclusion, preoperatively intravenous injection of LOR may effectively restrain the decreased serum levels of RANTES and the increased expression of MCP-1 and SDF-1alpha in TAH patients. LOR may help to maintain the stability of immune function of TAH patients.

Topics: Abdomen; Adult; Aged; Chemokine CCL2; Chemokine CCL5; Chemokine CXCL12; Cyclooxygenase Inhibitors; Female; Humans; Hysterectomy; Immune Tolerance; Middle Aged; Piroxicam; Postoperative Complications; Young Adult

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

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

To investigate the effects of intraperitoneally administered lornoxicam on adhesion formation, bursting pressure, tissue antioxidant levels, morbidity and mortality after ileocolic anastomosis in a rat bacterial peritonitis model.. Thirty-six rats were divided into three random groups. Bacterial peritonitis was induced by performing a cecal ligation and puncture, then the cecal was resected and ileocolic anastomosis was performed. Rats of groups 1, 2 and 3 were given 2 mL normal saline, 2 mL lornoxicam, and nothing, respectively. All groups were killed at day 14. Adhesions were scored, and the presence of intra-abdominal abscesses and fistulas were noted. Anastomotic healing was assessed by bursting pressure. Tissue antioxidant levels were tested from left abdominal walls.. One day after cecal ligation and puncture, microbiological examination showed polymicrobial bacterial peritonitis. The rats treated with lornoxicam had significantly lower adhesion scores than did the saline and nothing treated rats (P = 0.007). Bursting pressures of groups were unaffected by the treatment. Tissue antioxidant levels of groups were affected by the treatment. Morbidity and mortality were similar in all groups.. The present study demonstrated that a single intraperitoneal instillation of lornoxicam in buffer solution at the end of the surgery reduces adhesion formation in rats bacterial peritonitis model. It was also determined that lornoxicam had no negative effect on the healing of intestinal anastomosis, abscess and anastomotic leakage. Use of lornoxicam in peritonitis was effective in decreasing the oxidative stress of tissue during peritonitis.

Topics: Anastomosis, Surgical; Animals; Anti-Inflammatory Agents, Non-Steroidal; Disease Models, Animal; Female; Oxidative Stress; Peritonitis; Piroxicam; Postoperative Complications; Pressure; Rats; Rats, Wistar; Tissue Adhesions; Wound Healing