Postoperative patient-controlled analgesia with lornoxicam in patients undergoing gynecological surgery

Objective To assess the analgesic and side effects of patient controlled analgesia (PCA) with lornoxicam as compared with those with morphine. Methods 100 patients undergoing elective hysteromyomectomy were randomly divided into two groups: group L(n=49) received postoperative PCA with lornoxicam and group M (n=51) received PCA with morphine. Anesthesia was induced with propofol 2mg/kg and succinylcholine 1.5mg/kg and maintained with isoflurane and N 2O (N 2O: O 2=2:1) inhalation, intermittent iv boluses of vecuronium and continuous iv infusion of fentanyl 1μg·kg -1 ·h -1 . At the end of operation residual neuromuscular blockade was antagonized with neostigmine 40μg/kg and atropine 20μg/kg. In group L lornoxicam 32mg was diluted with normal saline to 16 ml, wihle in group M morphine 40mg was diluted with normal saline to 16ml. The bolus dose of PCA was 0.5ml (lornxicam 1mg /morphine 1.25mg) and lock out time 5min. The maximum dose of both drugs over 24h was lornoxicam 32mg or morphine 40mg . The efficacy of analgesia provided by PCA was assessed by: (1) pain intensity difference: the difference between intensity of pain immediately before PCA was started and at different internals during PCA; (2) pain relief : no pain relief=4, slight pain relief=3, moderate pain relief=2, obvious pain relief=1, no pain=0;(3) patient′s evaluation of the efficacy of PCA received; (4) side effects like nausea and vomiting ,dizziness, somnolence flushing of face, pruritus ,respiratory depression and abnormal bleeding etc. Results The two groups were comparable with regard to age , weight and duration of operation. There was no statistically significant difference in total pain relief [14 9±3 9(L) vs 15 2±3 7(M)] and sum of pain intensity difference[10.5±3.2(L) vs 9.4±3.0(M)] between the two groups (P0.05). Lornoxicam caused less side effects than morphine (10.2% vs 17.9%) Conclusions The study suggests that lornoxicam provide an alternative to morphine for the treatment of postoperative pain.