Droperidol Research Articles

Assessment of Diverse Solid-State Accelerated Autoxidation Methods for Droperidol.

The present study aimed to investigate methods for accelerating autoxidation of crystalline drugs in the solid-state that can potentially predict real−time stability. Solid droperidol (DPD) was selected as the model drug. A common free−radical initiator, 2,2′−azobisisobutyronitrile (AIBN), was used to induce autoxidation in solutions. AIBN decomposes at elevated temperatures to yield carbon−centred cyano−isopropyl free radicals that can auto−oxidize neighboring drug molecules. Although the reaction of AIBN is relatively straightforward in solution, it is less so in solids. In this study, we used solid AIBN mixed with DPD powder in the presence and absence of pressurized oxygen headspace. Samples were prepared directly in the form of binary mixtures with DPD and additionally in the form of powder compact/pellet with DPD. The main challenge in carrying out the reaction was related to the preservation of AIBN at elevated temperatures due to the disintegration of the pellet containing the latter. A commercially available free−radical coated silica particle (i.e., 2,2,6,6−tetramethyl−1−piperinyloxy (TEMPO) or (SiliaCATTM TEMPO)) was tested as a potential stressor, but with limited success to induce autoxidation. The most valuable results were obtained when a physical mixture of pre−milled PVP K−60 containing free radicals and DPD was exposed to elevated oxygen−temperature conditions, which yielded significant degradation of DPD. The study highlights the practical challenges for conducting accelerated solid−state stress studies to assess the autoxidation susceptibility of drugs using traditional free−radical initiators and presents a proof of application of milled PVP with free−radical as a potential alternative.

Contaminated batches of droperidol solution recalled in UK

Contaminated batches of droperidol solution recalled in UK

Haloperidol for Acute Headaches in the Emergency Department

Droperidol is effective for treatment of headaches, however, it is not available in many emergency departments (EDs). Haloperidol, in the same

The Surprising Re-emergence of Droperidol.

The Surprising Re-emergence of Droperidol.

Breakdown of the isochronal structural (α) and secondary (JG β) exact superpositioning in probucol - A low molecular weight pharmaceutical

In this paper, Broadband Dielectric Spectroscopy (BDS) has been applied to study the molecular dynamics of the two active pharmaceutical ingredients (APIs), probucol (PRO) and droperidol (DRO), above and below the glass transition temperature, at varying thermodynamic conditions. We found that the structural (α)-relaxation process in both compounds is sensitive to compression. It was reflected in the high pressure coefficients of the glass transition temperature, dTg/dp = 227 K/GPa and dTg/dp = 427 K/GPa for DRO and PRO, respectively. In this context, it is worthwhile to emphasize that dTg/dp calculated for the latter API is the highest reported to date for the low molecular weight glass formers. Furthermore, the data collected upon squeezing samples revealed that the pressure dependence of the relaxation times of the Johari Goldstein (JG) β-process in PRO is weaker with respect to that of structural relaxation. Thus, a breakdown of exact superposition of both modes has been noted. A slightly different scenario was observed in DRO, where relaxation times of the secondary non-JG γ-process, obtained at different T and p, plotted versus Tg/T, collapsed forming a single curve. A breakdown of exact isochronal superpositioning of α- and JG β-relaxation times at varying thermodynamic conditions in PRO, that is weakly H-bonded low molecular weight glass former, is in accordance with the data reported for the strongly associating compounds (e.g., sorbitol). Moreover, recently a similar scenario has been observed for some polymers, i.e., 1,4-polybutadiene (PBD) (Ransom et al., 2018), poly(methyl methacrylate) (PMMA) (Casalini and Roland, 2013) and polyisoprene (PI) (Kołodziej et al., 2018). This phenomenon, which is consistent with the approximate invariance of the ratio of these two relaxation times to change of thermodynamics conditions (as predicted by the Coupling Model), was assigned to the increasing torsional rigidity of the macromolecule backbone or alternatively to the non-uniform responses to variations of temperature and pressure of the distributed modes composing the JG β-process, resulting in changes of the spectral shape and different fβ(p,T) obtained from the fitting procedure. One can suppose that due to the variation in the population of weak H-bonds at elevated pressure in PRO, the latter effect might be enhanced, contributing to the observed experimental finding. Finally, the data reported herein emphasize the impact of molecular aspects related to specific interactions on the correlation between α- and JG β-relaxation at varying T and p conditions.

Alternatives to Haloperidol for Treating Acutely Agitated Patients in the ED

Haloperidol, droperidol, and olanzapine are widely used for treatment of acutely agitated patients, but few studies have compared their effectiveness

Droperidol dropped; consultants not consulted

AIMS AND METHOD We conducted a postal questionnaire survey of the practice of rapid tranquillisation among 215 consultant psychiatrists in the West of Scotland, before and after the withdrawal of droperidol by the manufacturer. RESULTS One hundred and eighty questionnaires (84% of those sent) were returned. Droperidol had been used extensively, often combined with lorazepam, for rapid tranquillisation. The main replacement suggested for droperidol was haloperidol. About half of the respondents to our survey chose to comment on the withdrawal of droperidol. More than half of the comments were unfavourable, including lack of an adequate replacement and lack of consultation with the psychiatric profession. CLINICAL IMPLICATIONS The abrupt withdrawal of droperidol, partly for commercial reasons, was regrettable. There was no time for an adequate evaluation of possible replacement medications and a lack of consultation with the profession regarding the impact on clinical care.

Addition of droperidol to prophylactic ondansetron and dexamethasone in children at high risk for postoperative vomiting. A randomized, controlled, double-blind study

BackgroundThe combination of dexamethasone (DEX), ondansetron (OND) and droperidol (DRO) is efficacious in preventing postoperative nausea and vomiting in adults, but has not been well assessed in children. MethodsChildren undergoing elective surgery under general anaesthesia and considered at high risk for postoperative vomiting (POV) were randomly assigned to receive a combination of DEX, OND and placebo (Group A) or a combination of DEX, OND and DRO (Group B). The primary outcome was the incidence of POV during the first 24 hours after surgery. We hypothesized that the addition of DRO to the standard antiemetic prophylaxis would provide a further 15% reduction in the residual risk for POV. The secondary outcome considered was any adverse event occurring during the study. ResultsOne hundred and fifty-three children, aged three to 16 years, were randomized to Group A and 162 to Group B. The overall incidence of POV did not differ significantly between the two groups, with 16 patients in Group A (10.5%) and 18 in Group B (11.1%) presenting with one or more episodes of POV, P=0.86. Fewer patients presented with adverse events in Group A (2%) compared with Group B (8%), P=0.01. Drowsiness and headache were the principal adverse events reported. ConclusionsThe addition of DRO to a combination of OND and DEX did not decrease POV frequency below that obtained with the two-drug combination in children at high risk of POV, but increased the risk of drowsiness. The combination of DEX and OND should be recommended in children with a high risk of POV. Clinical trial registrationNCT01739985.

Effect of IL-1RN genetic polymorphism on potency of fentanyl for postoperative intravenous analgesia

Objective To investigate the effect of IL-1RN genetic polymorphism on the potency of fentanyl for postoperative intravenous analgesia. Methods Two hundred and seventy patients of Han nationality(native of Henan province), aged 20-50 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing elective abdominal total hysterectomy or myomectomy under general anesthesia, were enrolled in this study.Blood samples were taken from the peripheral vein for DNA extraction using phenol chloroform extracting method, and polymerase chain reaction and agarose gel electrophoresis were used for IL-1RN genotying.The patients were assigned to one of 5 groups according to their genotypes: IL-1RN I/I wild homozygote group(group Ⅰ/Ⅰ), IL-1RN I/II mutation heterozygote group(group Ⅰ/Ⅱ), IL-1RN II/II mutation homozygote group(group Ⅱ/Ⅱ), IL-1RN I/III mutation heterozygote group(group Ⅰ/Ⅲ), and IL-1RN I/IV mutation heterozygote group(group Ⅰ/Ⅳ). Pain was assessed using visual analogue scale(VAS)score after the patients recovered from anesthesia.When VAS score>3, the patients were given fentanyl 20 μg every 5 min until VAS score decreased to ≤3.Patient-controlled intravenous analgesia(PCIA)with fentanyl was then started.The PCIA solution contained fentanyl 1.0 mg and droperidol 5 mg in 100 ml of normal saline.The PCA pump was set to deliver a background infusion of 0.5 ml/h and a bolus dose of 2 ml at 5 min lockout interval.The VAS score was maintained≤3.The amount of fentanyl consumed within 24 h of PCIA was recorded. Results A total of 224 patients were genotyped successfully.Among the 224 patients, there were 210 cases in group Ⅰ/Ⅰ, 6 cases in group Ⅰ/Ⅱ, 4 cases in group Ⅱ/Ⅱ, 3 cases in group Ⅰ/Ⅲ, and 1 case in groupⅠ/Ⅳ(excluded). There was no significant difference in the amount of fentanyl consumed within 24 h of PCIA among the four groups(P>0.05). Conclusion IL-1RN genetic polymorphism is not related to the hereditary factor contributing to the individual variation in the patient′s response to postoperative intravenous analgesia with fentanyl. Key words: Receptors, interleukin-1; Polymorphism, single nucleotide; Fentanyl; Analgesia; Dose-response relationship, drug

Hydrogen Bonding: Between Strengthening the Crystal Packing and Improving Solubility of Three Haloperidol Derivatives.

The purpose of this study is to confirm the impact of polar functional groups on inter and intra-molecular hydrogen bonding in haloperidol (HP) and droperidol (DP) and, hence, their effects on dissolution using a new approach. To confirm our theory, a new molecule: deshydroxy-haloperidol (DHP) was designed and its synthesis was requested from a contract laboratory. The molecule was then studied and compared to DP and HP. Unlike DHP, both the HP and DP molecules have hydrogen donor groups, therefore, DHP was used to confirm the relative effects of the hydrogen donor group on solubility and crystal packing. The solid dispersions of the three structurally related molecules: HP, DP, and DHP were prepared using PVPK30, and characterized using XRPD and IR. A comparative dissolution study was carried out in aqueous medium. The absence of a hydrogen bonding donor group in DHP resulted in an unexpected increase in its aqueous solubility and dissolution rate from solid dispersion, which is attributed to weaker crystal pack. The increased dissolution rate of HP and DP from solid dispersions is attributed to drug-polymer hydrogen bonding that interferes with the drug-drug intermolecular hydrogen bonding and provides thermodynamic stability of the dispersed drug molecules. The drug-drug intermolecular hydrogen bond is the driving force for precipitation and crystal packing.

Is Ketamine a Safe and Effective Rescue Treatment for Severely Agitated ED Patients

Researchers assessed the safety and effectiveness of ketamine for rescue sedation in a substudy of severely agitated and violent patients. In the parent study, roughly 1300 patients at two emergency departments (EDs) were managed with a standardized sedation protocol recommending 10-mg intramuscular droperidol as first-line treatment. After initial attempts at sedation failed, 49 of these patients (median age, 37; 57% men were given 4–6-mg/kg IM …

Effect of surgical trauma on Toll-like receptor 4 expression in hippocampus of aged mice

Objective To investigate the effects of surgical trauma on Toll-like receptor 4(TLR4)expression in the hippocampus of aged mice. Methods Ninety male Kunming mice, aged 16-18 months, weighing 30-40 g, were randomly divided into 3 groups(n=30 each)using a random number table: control group(group C), anesthesia group(group A), and partial hepatectomy group(group PH). Normal saline 0.1 ml/10 g was injected intraperitoneally in group C. In group A, fentanyl 0.2 mg/kg and droperidol 5 mg/kg were injected intraperitoneally.In group PH, fentanyl 0.2 mg/kg and droperidol 5 mg/kg were injected intraperitoneally, and the mice underwent partial hepatectomy.Cognitive function was assessed using Morris water maze test at 1, 3, and 7 days after anesthesia or surgery.After the end of the test, the hippocampus was immediately harvested for determination of the TLR4, tumor necrosis factor-alpha(TNF-α)and interleukin-1 beta(IL-1β)protein and mRNA expression by Western blot and real-time reverse transcriptase-polymerase chain reaction, respectively. Results Compared with group C, no significant changes were found in group PH in the escape latency, percentage of swimming distance in the target quadrant, and TLR4, TNF-α and IL-1β protein and mRNA expression at each time point after anesthesia in group A(P>0.05), and the escape latency was significantly prolonged, the percentage of swimming distance in the target quadrant was decreased, and the expression of TLR4, TNF-α and IL-1β protein and mRNA was up-regulated at 1 and 3 days after surgery in group PH(P<0.05 or 0.01). Compared with group A, the escape latency was significantly prolonged, the percentage of swimming distance in the target quadrant was decreased, and the expression of TLR4, TNF-α and IL-1β protein and mRNA was up-regulated at 1 and 3 days after surgery in group PH(P<0.05 or 0.01). Conclusion Surgical trauma can up-regulate the expression of TLR4 in the hippocampus of aged mice, which may be involved in the mechanism of surgical trauma-induced postoperative cognitive dysfunction. Key words: Surgical procedures, operative; Cognition disorders; Aged; Toll-like receptor 4

Targeting islet cell using 18F-Fallypride: in vitro and histoautoradiography study

Objective To evaluate the feasibility of dopamine D2 receptor imaging agent (s)-(-)-N-(1-allylpyrrolidine-2-N-methyl)-5-(3-18F)-2, 3-dimethoxy Benzamide (18F-Fallypride) for targeting islet cell imaging. Methods (1) Cytology experiment: Islet cells of 15×103 cells/well were incubated with 3.70 kBq/well 18F-Fallypride for 1 h and the uptake rate of cells was calculated (cell counts/(supernatant counts+cell counts)×100%). Under the same experiment conditions, 6 inhibiting groups were administrated with different concentration of dopamine inhibitors droperidol (1.0×10-6, 4.0×10-6, 2.0×10-5, 1.0×10-4, 5.0×10-4 and 1.0×10-3 mol/L, respectively). After 30 min, 3.70 kBq of 18F-Fallypride was added to each inhibiting group, and the inhibiting rate was calculated. (2) Autoradiography: 18 normal ICR mice were divided into 6 groups. For group A, ICR mice were injected with 18F-Fallypride (55±5) MBq/mice through tail vein. For the other 5 inhibiting groups (group B-F), ICR mice were injected with different doses of droperidol (0.2, 0.4, 0.6, 0.8 and 1.0 mg/kg, respectively), and after 30 min 18F-Fallypride were injected through tail vein. Ten minutes later, pancreas of ICR mice was taken for preparation of tissue section autoradiography. The data were analyzed by one-way analysis of variance and the least significant difference t test. Results (1) The 18F-Fallypride uptake rate of control group was (18.40±1.21)%. The uptake rates of inhibiting groups were (16.11±1.37)%, (15.76±0.99)%, (13.90±1.02)%, (8.86±0.73)%, (7.26±0.62)% and (6.92±0.58)%, respectively, which decreased with the decreasing concentration of droperidol(F=50.01, P<0.01). When the concentration of droperidol was 1.0×10-4 mol/L, the uptake rate reached the lowest with inhibiting rate of 51.85%. (2) The autoradiography showed that the pancreas gray scale value of group A was 1.21×106 digital light units (DLU)/mm2. The pancreas gray scale value of groups B to F decreased with increasing concentration of inhibitor: 0.93×106, 0.77×106, 0.59×106, 0.32×106 and 0.25×106 DLU/mm2, respectively. Conclusions 18F-Fallypride may specifically and efficiently bind to dopamine receptors of islet cells. It may be a potential tracer for islet cells imaging. Key words: Islets of langerhans; Fallypride; Fluorine radioisotopes

Another Study Shows That Droperidol Is a Safe Sedative

In 2001, the FDA issued a warning about droperidol as a potential cause of QT prolongation and torsades de pointes. But the evidence for an association was weak (NEJM JW Emerg Med Jul 2003 and Ann Emerg Med 2003; 41:546), and subsequent studies have shown droperidol to be safe and effective not only …

The anesthesia effect in patients undergoing artificial abortion treated with droperidol and pethidine hydrochloride in combination with paracervical block

Objective To analyze the anesthesia effect of droperidol and pethidine hydrochloride in combination with paracervical block in artificial abortion. Methods 386 patients undergoing artificial abortion were admitted. They were randomly divided into the two groups. The study group(193 cases)was treated with droperidol and pethidine hydrochloride in combination with paracervical block, while the control group(193 cases)was treated with droperidol and pethidine hydrochloride only.The analgesic effect, hemodynamics, cervix relaxation and side effects between the two groups were compared. Results The analgesic effect of the study group was 91.7%,which was much higher than 72.0%of the control group(χ2=25.198,P<0.01), and there were significant differences between the two groups in hemodynamics(t=4.545,3.674,all P<0.01). The total cervix relaxation were 102 cases, and partly cervix relaxation were 69 cases in the study group, which were significantly higher than that of the control group(69 cases,60 cases, respectively;Z=4.643,P<0.01). There was no difference between side effects except for abortion syndrome(χ2=7.580,P=0.006). Conclusion Droperidol and pethidine hydrochloride in combination with paracervical block have an excellent effect on artificial abortion. Key words: Droperidol; Pethidine hydrochloride; Lidocaine; Anesthetics, Local; Abortion, Induced

Effects of exendin-4 on GFAP and IL-1βexpression in hippocampi of aged rats

Objective To evaluate the effects of exendin-4 on glial brillary acidic protein （GFAP ） and interleukin-1β（IL-1β） expression in hippocampi of aged rats .Methods Forty-eight healthy male Sprague-Dawley rats ,aged 22-24 weeks ,weighing 500-700 g ,were randomly divided into 4 groups （n=12 each） using a random number table：control group （group C ） ,exendin-4 group （group E ） ,operation group （group O ） and exendin-4 plus operation group （group OE） .The rats were anesthetized with intraperitoneal fentanyl and droperidol .Groups C and E did not receive anesthesia or splenectomy .In O and OE groups ,splenectomy was carried out .In E and OE groups , exendin-4 5 μg/kg was injected intraperitoneally at 30 min before skin incision and 12 h after operation .C and O groups received the equal volume of normal saline instead of exendin-4 .Learning and memory function was assessed using Morris water maze test （escape latency （EL） and total swimming distance （TSD） at 1 day before operation （T0 ） .The fasting blood glucose was measured after anesthesia （T1 ） ,at the end of operation （T2 ） and on postoperative day 1 （T3 ） .The rats were sacrificed after assessment of the cognitive function at T 3 and the hippocampi were removed for determination of the expression of GFAP （by immuno-histochemistry ） and IL-1β（by Western blot ） .Results There was no significant difference in the EL and TSD at T0 between the four groups＆nbsp;（ P〉0.05） .Compared with group C ,the EL and TSD were significantly prolonged at T3 and fasting blood glucose was increased at T2 ,3 ,and the expression of IL-1βand GFAP was up-regulated at T3 in O and OE groups （ P〈0.05） .Compared with group O ,the EL and TSD were significantly prolonged at T3 and fasting blood glucose was decreased at T2 ,3 ,and the expression of IL-1βand GFAP was down-regulated at T3 in group OE （ P〈0.05） . Conclusion Exendin-4 can improve the postoperative cognitive function of aged rats by inhibiting inflammatory responses in hippocampi and maintaining stable perioperative blood glucose . Key words: Glucagon-like peptide 1; Cognition disorders; Hippocampus; Inflammation; Blood glucose

A Plea for the Cautious Use of Droperidol

A Plea for the Cautious Use of Droperidol

Effect of potentiated anesthesia of dexmedetomidine in patients with incomplete brachial plexus block

Objective To evaluate the effect of potentiated anesthesia of dexmedetomidine (DEX) when brachial plexus block were unsuccessful.Methods 42 patients with incomplete brachial plexus block were randomly divided into 2 groups(group A and group B,n=21).Sauteralgyl 25 mg and droperidol 2.5 mg were used in group A,0.8 μg/kg of DEX were used in group B within 10 min as a bolus,and 0.4 μg ·kg-1 ·h-1 of DEX were infused continuously until the end of the operation.Systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR),transcutaneous oxygen saturation (SpO2),visual analogue scale (VAS),Ramsay score and other side effects were recorded before potentiated anesthesia (T0) and 5(T1),10(T2),30 min (T3) after potentiated anesthesia and end of operation(T4).Results Compared with group A,VAS were lower in group B[0(3.5) vs 3.5(3),0(1)vs 2(2.75),0(1) vs 2.5(3) at T1,T2,T4,respectively,P＜0.05].The Ramsay score in group B were higher than that of group A [(2.8±0.9) vs (1.8±0.9),(3.9±0.3) vs (2.8±0.9),(3.7±0.7) vs (2.7±0.9),(2.3±0.6) vs (1.3±0.8) at T1,T2,T3,T4,respectively,P＜0.01].There were no significant difference between two groups in other side effects such as hypotension,sinus bradycardia,nausea and vomiting(P＞0.05).There were no significant difference between two groups at each time point in SBP,DBP,HR and SpO2(P＞ 0.05),although there were significant difference among each group in SBP,DBP,HR(P＜0.01).Conclusions DEX can be used to strengthen the effect of brachial plexus block,with good analgesia and sedation,and high safety. Key words: Dexmedetomidine; Potentiated anesthesia; Brachial plexus; Nerve block

Efficacy of ondansetron for postoperative nausea and vomiting in patients undergoing gynecological laparoscopic surgery: a meta-analysis of randomized controlled trials

Objective To evaluate the effcacy and safety of 5-HT3 receptor inhibitor ondansetron injected in the postoperative nausea and vomiting (PONV) in patients undergoing gynecological laparoscopic surgery under general anesthesia.Methods We searched the CNKI,CBM,Chongqing VIP,Wanfang Data Base,Pubmed,Springer,Embase,and Web of knowledge to identify randomized controlled trials (RCTs) about ondansetron in preventing PONV in patients undergoing gynecological laparoscopic surgery under general anesthesia from 1995 to 2012.We also consulted references of the included studies for omission.The methodological quality of the included RCTs was assessed and data were extracted according to the standard of the Cochrane Handbook 5.0.1.The meta-analyses were performed by Stata1 1.0 software.A total of 18 RCTs involving 1 597 patients were included.Results The results of meta-analyses showed that:① Effcacy:a single intravenous injection of ondansetron could decrease the incidence of PONV in patients undergoing gynecological laparoscopic surgery under general anesthesia (RR=0.210,95％CI=0.164-0.268),and a single 8 mg Ⅳ dose of ondansetron is no more effective than a single 4 mg Ⅳ dose of Ondansetron for prevention (RR=0.948,95％ CI =0.433-2.075),furthermore,ondanstron administered at the beginning of the gynecological laparoscopic procedures is more effective in preventing PONV than at the end of the surgery (RR=0.450,95％CI=0.290-0.698).Moreover,equivalent effcacy was seen between the ondansetron and droperidol in reducing PONV in patients undergoing gynecological laparoscopic survey,but the combination of ondansetron and droperidol further attenuated this incidence when compared to 4 mg ondansetron alone.② Safety:ondansetron injected could not significantly lessen the incidence of postoperative headache and fever.Conclusions A single 4 mg Ⅳ dose of ondansetron injected at the beginning of the gynecological laparoscopic survey can significantly decrease the incidence of PONV after general anesthesia,and it will not increase the adverse effect and the incidence of postoperative complications.And the combination of ondansetron and low dose of droperidol is more efficacious as a prophylactic antiemetic than ondansetron alone in women undergoing general anesthesia for gynecological laparoscopy. Key words: Randomized controlled trials; Meta-analysis; Ondansetron; Postoperative nausea and vomiting; gynecological; laparoscopic surgery

Effect of lornoxicam on postoperative inflammatory reaction in patients undergoing laparoscopic appendectomy

Objective To investigate the effects of lornoxicam on postoperative inflammatory reaction in patients undergoing laparoscopic appendectomy.Methods Sixty ASA Ⅰ - Ⅱ patients undergoing laparoscopic appendectomy were assigned to study group and control group ( 24 for each ).The study group received intravenous loronoxicam of 8 mg diluted with normal saline of 2ml before anesthesia,and the control group received the same volume of normal saline.All the patients were anesthetized with combined spinal and epidural blockage and tranquilized with pethedine,droperidol,and diazepam.Peripheral vein blood were extracted one hour before surgery and one day after operation to measure leukocyte count; the concentration of C reaction protein ( CRP ) was detected.Results Leukocyte count and CRP concentration were markedly decreased ond day after surgery in both groups ( P＜ 0.05 ).Leukocyte count and CRP concentration were significantly lower in the study group than in the control groupt[( 5.4 + 3.7 ) vs.( 7.6 +3.2) and (6.4 ± 3.7) vs.(9.6 ± 4.1 ),P＜ 0.05 for both comparisons].Conclusions Intravenous lornoxicam before anesthesia can suppress inflammatory reaction during early postoperative stage in patients undergoing laparoscopic appendectomy. Key words: Lomoxicam; Laparoscopy; Appendectomy; Postoperation; Inflammatory reaction