Comparison of effects of preoperatively administered lornoxicam and tenoxicam on morphine consumption after laparoscopic cholecystectomy

Kocaayan, E.*; Ozkardeşler, S.; Ozzeybek, D.; Bayndr, S.¶ıı; Akan, M.

European Journal of Anaesthesiology: August 2007 - Volume 24 - Issue 8 - p 714–719
doi: 10.1017/S0265021507000300
Original Article

Background and objective:: The efficacy, tolerability and the morphine‐sparing effects of lornoxicam were compared with those of tenoxicam when used preoperatively in patients undergoing laparoscopic cholecystectomy.

Methods:: In this prospective, double‐blind study, 60 ASA I–II patients undergoing laparoscopic cholecystectomy were randomized equally to receive intravenous tenoxicam 40 mg (Group T) or lornoxicam 16 mg (Group L), preemptively. Three patients withdrew from the study, so 57 patients were included in the analysis. In the postoperative period, the first morphine demand times, pain scores, side‐effects and cumulative morphine consumptions were evaluated during the first 24 h.

Results:: The patient characteristics data and the duration of surgery were similar between two groups, except for body weights (P = 0.002). The first morphine demand time was significantly longer in Group L (P = 0.037), but the pain levels did not differ. The mean pain scores were higher in Group T in the 15 min (P = 0.036), 1 h (P = 0.020), 2 h (P = 0.001) and 4 h (P = 0.0042) after extubation. A statistically significant difference between two groups was found in calculated cumulative morphine consumptions per kilogram in the 15 min (P = 0.037), 30 min (P = 0.016), and 1 h (P = 0.004) and 2 h (P = 0.013) between two groups. There was no difference in the severity of nausea but 13 patients in Group T and five patients in Group L had vomiting (P = 0.018). Patient satisfaction was similar in the two groups.

Conclusions:: Preoperatively administered lornoxicam 16 mg significantly prolonged the first morphine demand time, reduced postoperative morphine consumption during the first 4 h and caused significantly fewer adverse effects when compared with tenoxicam after laparoscopic cholecystectomy.

*Universal Hospital, Department of Anaesthesiology, Manisa, Turkey

Dokuz Eylül University, Medical School, Department of Anaesthesiology, Izmir, Turkey

Niksar State Hospital, Department of Anaesthesiology, Tokat, Turkey

Correspondence to: Deniz Ozzeybek, Department of Anaesthesiology, Medical School, Dokuz Eylül University, 752 sok. No: 54/17 Özege Sitesi 35310, Güzelbahçe, İzmir, Turkey. E‐mail: deniz.ozzeybek@deu.edu.tr; Tel: +90 232 4122816; Fax: +90 232 4122800

Accepted for publication 9 February 2007

First published online 22 May 2007

© 2007 European Society of Anaesthesiology