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

Eur J Anaesthesiol. 2008 Mar;25(3):177-82. doi: 10.1017/S0265021507002827. Epub 2007 Oct 22.

Abstract

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

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

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

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

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Analgesia, Patient-Controlled / methods
  • Analgesia, Patient-Controlled / statistics & numerical data*
  • Analgesics, Opioid / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Dipyrone / administration & dosage
  • Dipyrone / adverse effects
  • Dipyrone / therapeutic use*
  • Double-Blind Method
  • Elective Surgical Procedures
  • Female
  • Humans
  • Infusions, Intravenous
  • Male
  • Meperidine / administration & dosage
  • Middle Aged
  • Nasal Septum / surgery*
  • Pain Measurement / methods
  • Pain Measurement / statistics & numerical data
  • Pain, Postoperative / drug therapy*
  • Piroxicam / administration & dosage
  • Piroxicam / adverse effects
  • Piroxicam / analogs & derivatives*
  • Piroxicam / therapeutic use
  • Postoperative Nausea and Vomiting / chemically induced
  • Postoperative Nausea and Vomiting / prevention & control
  • Prospective Studies
  • Rhinoplasty*
  • Time Factors
  • Treatment Outcome

Substances

  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal
  • Piroxicam
  • Dipyrone
  • Meperidine
  • lornoxicam