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

Öz

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.

Anahtar Kelimeler

• Preemptive analgesia, lornoxicam, tramadol, postoperative, pain relief

Laparoskopik kolesistektomi uygulanan hastalarda, ameliyat öncesi uygulanan lornoksikam ve tramadol\'un postoperatif ağrı üzerine olan etkilerinin karşılaştırılması

Öz

Amaç: Postoperatif ağrı, akut ağrının en sık nedenlerinden biridir. Postoperatif ağrı tedavisinin klasik şekli parenteral opioid uygulamasıdır. Bu randomize çift-kör çalışmada preemptif uygulanan lornoksikam ve tramadolün analjeziklerin etkinliklerinin karşılaştırılması amaçlandı. Hastalar ve Yöntem: Toplam 76 hasta randomize olarak dört gruba ayrıldı. Tüm hastalar operasyondan 4 saat öncesi tablet aldılar. Grup PL preemptif olarak 4 mg lornoksikam, Grup PT 50mg tramadol alırken, Grup L ve T ise plasebo tablet aldılar. Operasyon sonunda Grup PL\'ye 8 mg/saat infüzyon ve 1 mg bolus lornoksikam; Grup L\'ye 1.6mg yükleme, 8 mg/saat infüzyon ve 1 mg bolus lornoksikam; Grup PT\'ye 5 mg/saat infüzyon ve 10 mg bolus tramadol; Grup T\'ye 20 mg yükleme, 5 mg/saat infüzyon ve 10 mg bolus tramadol hasta kontrollü (PCA) ile 24 saat boyunca uygulandı. Ağrı şiddeti 0,1., 2., 3., 6., 10., 24. saatlerde kaydedildi ve 24 saat sonunda genel ağrı iyileşmesi değerlendirildi. Bulgular: Gruplar arasında demografik bulgular, operasyon süresi, kalp hızı ve ortalama kan basınç değerleri bakımından anlamlı fark gözlenmedi. Grup PL ve PT de Grup L ve T ye göre daha düşük ağrı şiddeti ve daha hızlı ağrı iyileşmesi görüldü. Grup PL ve PT\'de daha az total analjezik tüketimi ve daha yüksek ağrı tedavisi memnuniyeti bulundu. Tüm gruplar birbirleriyle karşılaştırıldığında, 24 saatlik ağrı tedavisi en iyi Grup PL\'de bulundu. Ağrı şiddeti tüm zamanlarda Grup T\'de en yüksek, Grup PL\'de ise en düşük bulundu. Sonuç: Analjezi etkisi lornoksikam grubunda daha önce başlarken, ilaç ihtiyacı tramadol gruplarında daha fazla idi. Cerrahi girişim sonunda PCA kullanımı ile benzer ağrı iyileşmesi görüldü. Bu çalışma postoperatif ağrı tedavisinde analjeziklerin preemptif uygulanmasının daha fazla analjezi sağlayabileceğini düşündürmektedir.

Anahtar Kelimeler

• Preempetif analjezi, lornoksikam, tramadol, postoperatif, ağrı giderilmesi

Kaynakça

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