Comparing efficacy of preemptively used lornoxicam and tramadol for postoperative pain in patients underwent laparoscopic cholecystectomy

Abstract

Objectives: The management of postoperative pain is an important problem in Anesthesiology. This randomized double-blind study compared the analgesic efficacy of preemptively used lornoxicam and tramadol in patients underwent laparoscopic cholecystectomy. Methods: A total of 76 patients were randomly divided into four groups. All patients received tablets 4 hours before the operation. Preemptively Group PL received 4 mg lornoxicam, Group PT received 50 mg tramadol and Group L and T received placebo. After the operation Group PL received 0.8 mg/h infusion and 1 mg bolus lornoxicam; Group L 1.6 mg loading, 0.8 mg/h infusion and 1 mg bolus lornoxicam; Group PT 5 mg/h infusion and 10 mg bolus tramadol; Group T 20 mg loading, 5 mg/h infusion and 10 mg bolus tramadol for 24 hours. Pain intensity and pain relief at 0, 1st, 2nd, 3rd, 6th, 10th, 24th hours and overall assessment of pain relief was done at 24th hour. Results: Demographic features, operation time, heart rate and mean arterial blood pressure values were not different between four groups. Both Group PL and PT had lower pain intensity and higher pain relief values than Group L and T. Group PL and PT had lower total drug consumption and higher pain relief. Overall assessment of pain relief was highest in Group PL. Pain intensity was highest in Group T and lowest in Group PL at all time points. Conclusion: Onset of analgesia with lornoxicam was faster and greater patient-controlled analgesia (PCA) demand was observed with tramadol. Postoperative pain relief was similar with lornoxicam and tramadol administrated by PCA. This study suggests that preemptive administration of lornoksikam and tramadol may result in more postoperative pain relief.