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Treatment of Pain after Spinal Surgery in the Recovery Room by Single Dose Lornoxicam: A Randomized, Double Blind, Placebo-Controlled Trial

650

Somboon Thienthong MD*, Kitti Jirarattanaphochai MD**,
Wimonrat Krisanaprakornkit MD*, Suthannee Simajareuk BSc*,
Wattana Tantanatewin BSc*, Aksorn Sathitkarnmanee BSc*
* Department of Anesthesiology, Faculty of Medicine, Khon Kaen University
** Department of Orthopaedics, Faculty of Medicine, Khon Kaen University

Abstract


Background : Lornoxicam has been used in microsurgical lumbar discectomy. However, there is no data
about controlling pain after open discectomy or laminectomy.
Objective : To compare the efficacy of a single dose of 16 mg of lornoxicam for the treatment of pain after
disectomy or laminectomy with placebo in the PACU.
Study design : Randomized, double blind, placebo-controlled trial.
Material and Method : Fifty-six patients who underwent disectomy or laminectomy were randomly allocated
to receive 16 mg lornoxicam (Group L), or placebo (Group P) at the beginning of wound closure. Pain scores
at rest (using a verbal numeric rating scale: VNRS 0-10), time to first analgesia requirement, morphine
consumption during the first 2 hr after surgery and adverse effects were all recorded. The outcomes were
assessed on admission to the PACU (T0), then at 1 (T1) and 2 (T2) hr after surgery.
Results : Baseline data were comparable between the two groups. The proportion of patients with VNRS > 5
at T0 in both groups were not significantly different (44.4% in group P vs 50.0% in group L, CI of difference:
- 32.4%, 21.3%, p = 0.68). The mean VNRS scores, at T0 and T1 were > 5 and at T2 was < 5 in both groups.
There was no difference between the two groups.
The morphine consumption in both groups was not different (9.0 mg vs 9.3 mg) as well as the time to
first analgesia requirement (35 min vs 40 min).
Patients in the two groups had no significant difference in the symptoms or degree of nausea/
vomiting. The number of patients with excessive sedation and the proportion of patients needing oxygen
during transportation to the ward were not different.
Conclusion : Lornoxicam 16 mg given intravenously before wound closure provides inadequate pain relief
immediately after disectomy or laminectomy in the PACU. However, adequate pain relief was demonstrated at
2 hr after surgery, which was similar to the placebo.


Keyword : Lornoxicam, Postoperative pain, Spinal surgery, PACU



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