An Evaluation of the Efficacy of Lornoxicam in Acute Renal Colic Treatment

Öz

Purpose: In order to provide analgesia in renal colic, related to acute urinary obstruction, many different agents are used. Use of prostaglandin synthesis inhibitors is very common for this purpose. In our study, we aim to evaluate the analgesic effect of lornoxicam, included in above mentioned group, in renal colic treatment. Materials and Methods: The patients, who were taken to emergency room due to renal colic, were assigned into two group. Before any treatment, they were evaluated with visual analog pain scale, using darkening color scores between 0 to 10. Group 1: 8mg injectable lornoxicam was administrated, Grup 2: 75mg diclofenac sodium I.M was injected. Following treatment, at 15, 30, and 60th minutes, all patients were reevaluated for pain by using visual analog scale. Results: Initially, 213 patients were recruited for baseline evaluation and 129 of them, were included in the study. Before treatment, mean pain scores of the patients in Group 2 were found to be (S0) 6.10, whereas before treatment mean pain scores of the patients in Group 1 were found to be (S0) 6.04, (p=0.868). While means of pain scores (S15, S30, S60) at 15, 30, and 60th were found as 1.46, 0.84, and 0.63 respectively in Group 1, in Group 2, these values were found 3.75, 1.96, and 1.50 respectively and it was found that there was a statistically significant difference between the values (S15: p<0.001, S30: p=0.001, S60: p=0.01). Conclusions: Lornoxicam provides an effective analgesia within a short time in acute renal colic treatment and can be tolerated well by the patients. Lornoxicam may be one of the good alternatives for renal colic treatment. Key words: Acute renal colic, Lornoxicam, Treatment

Anahtar Kelimeler

• Acute renal colic, Lornoxicam, Treatment

Akut Renal Kolik Tedavisinde Lornoksikam’ın Etkinliğinin Değerlendirilmesi

Öz

Amaç:Akut üriner obstrüksiyonla ilişkili renal koliğin analjezisini sağlamak için farklı ajanlar kullanılmıştır.Bu konuda sıklıkla prostaglandin sentez inhibitörleri kullanılır.Çalışmamızda renal kolik tedavisinde yukarıda adı geçen gruba dahil olan lornoksikamın analjezik etkinliğini araştırmayı amaçladık. Gereç ve Yöntem: Renal kolik nedeniyle acil servise gelen hastalar iki gruba ayrıldı. Herhangibir tedaviden önce hastalar 0 ile 10 arasında renkleri koyulaşarak skorlanan visüel analog ağrı skorlaması ile değerlendirildi.Birinci gruba 8 mg lornoksikam, ikinci gruba 75 mg IM diklofenak sodyum enjekte edildi.Tedaviyi takiben bütün hastalardaki ağrı 15, 30 ve 60. dakikalarda tekrar yüzeyel analog skala ile değerlendirildi. Sonuçlar:Başlangıçta temel değerlendirme için 213 hasta seçildi bunların seçilme kriterlerine sahip 129 u da çalışamaya dahildi.Tedavi öncesi grup 2nin ortalama ağrı skoru (S0) 6.10 iken birinci grubun skoru (S0) 6.04 bulundu (p=0,868). Hastaların 15, 30 ve 60. dakikalarda (S15, S30, S60 ) ortalama ağrı skorları birinci grupta sırasıyla 1.46, 0.84 ve 0.63 ikinci grupta bu değerler sırasıyla 3.75, 1.96 ve 1.50 bulundu ki bu değerler arasındaki fark istatistiksel olarak anlamlı bulundu ( S15 : p<0.001, S30 : p=0,001, S60 : p=0,01). Karar: Lornoksikam akut renal koliğin tedavisinde hastalar tarafından iyi tolere edilen kısa zamanda etkili bir analjezi sağlar.Lornoksikam renal koliğin tedavisinde iyi bir alternatif olabilir. Anahtar kelimeler: Akut renal kolik, Lornoksikam, Tedavi

Anahtar Kelimeler

• Akut renal kolik, Lornoksikam, Tedavi

Kaynakça

1. Gulmi FA, Felsen D, Vaughan ED. Pathophysiology of urinarytract obstruction. In Walsh PC, Retik AB, Vaughan ED, Weir AJ, eds, Campbell's Urology, 7th edn. Vol. 1, Chapt. 9. Philadelphia: WB Saunders, 1998: 342-85.
2. Al-Waili NSD. Intramuscular tenoxicam to treat acute renalcolic. Br J Urol 1996; 77(1): 15-6.
3. Curry C, Kelly AM. Intravenous tenoxicam for the treatment of renal colic. NZ Med J 1995; 108: 229±30
4. Rosenow DE, Albrechtsen M, Stolke D. A comparison of patient-controlled analgesia with lornoxicam versus morphine in patients undergoing lumbar disk surgery. Anesth Analg. 1998 May;86(5):1045-50.
5. Aabakken L, Osnes M, Frenzel W. Gastrointestinal tolerability of lornoxicam compared to that of naproxen in healthy male volunteers. Aliment Pharmacol Ther. 1996 Apr;10(2):151-6.
6. Radhofer-Welte S, Rabasseda X. Lornoxicam, a new potent NSAID with an improved tolerability profile. Drugs Today 2000 Jan;36(1):55-76.
7. Balabanova RM, Fedina TP, Tsurko VV, Mach ES, Khitrov NA, Agapova LA, Oliunin IuA, Pushkova OV, Apenysheva NP. Dynamic changes in synovitis activity after intra-articular administration of xefocam in patients with rheumatoid arthritis Ter Arkh. 2003;75(5):33-5
8. Frizziero L, Focherini MC, Valentini M, Reta M, Rocchi P. Long term study on the efficacy and safety of lornoxicam in rheumatoid arthritis Minerva Med. 2002 Aug;93(4):315-20.

9. Nikoda VV, Maiachkin RB, Bondarenko AV. Clinical aspects of using patient- controlled analgesia with nonsteroidal anti-inflammatory agents in postoperative period. Anesteziol Reanimatol. 2003 Sep-Oct;(5):56-9.
10. Gong ZY, Ye TH, Qin XT, Yu GX, Guo XY, Luo AL. Patient-controlled analgesia with lornoxicam in patients undergoing gynecological surgery. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2001 Oct;23(5):472-5.
11. Thienthong S, Jirarattanaphochai K, Krisanaprakornkit W, Simajareuk S, Tantanatewin W, Sathitkarnmanee A. Treatment of pain after spinal surgery in the recovery room by single dose lornoxicam: a randomized, double blind, placebo- controlled trial. J Med Assoc Thai. 2004 Jun;87(6):650-5.
12. Trampitsch E, Pipam W, Moertl M, Sadjak A, Dorn C, Sittl R, Likar R. Preemptive randomized, double-blind study with lornoxicam in gynecological surgery. Schmerz. 2003 Jan;17(1):4-10.
13. Z. Kekeç, U. Yılmaz, E. Sözüer. The effectiveness of tenoxicam vs isosorbidedinitrate plus tenoxicam in the treatment of acute renal colic. BJU International 2000, 85, 783±785.
14. Al-Waili NS, Saloom KY. Intravenous tenoxicam to treat acute renal colic: comparison with buscopan compositum. J Pak Med Assoc. 1998 Dec;48(12):370-2.
15. Al-Waili NS, Saloom KY. Intramuscular piroxicam versus intramuscular diclofenac sodium in the treatment of acute renal colic: double-blind study. Eur J Med Res. 1999 Jan 26;4(1):23-6.
16. Kidd B, Frenzel W. A multicenter, randomized, double blind study comparing lornoxicam with diclofenac in osteoarthritis. J Rheumatol. 1996 Sep;23(9):1605-11.
17. Warrington SJ, Lewis Y, Dawnay A, Johnston A, Kovacs IB, Lamb E, Ravic M. Renal and gastrointestinal tolerability of lornoxicam, and effects on haemostasis and hepatic microsomal oxidation. Postgrad Med J. 1990;66 Suppl 4:S35-40.
18. Balfour JA, Fitton A, Barradell LB. Lornoxicam. A review of its pharmacology and therapeutic potential in the management of painful and inflammatory conditions. Drugs. 1996 Apr;51(4):639-57.
19. Address for Correspondence: Gökhan TEMELTAS
20. Celal Bayar University, School of Medicine
21. Department of Urology, 45010 Manisa/ TURKEY. Tel : [phone] Fax : [phone]
22. E-mail: [e-mail]