title: Patient-controlled analgesia with lornoxicam vs. dipyrone for acute postoperative pain relief after septorhinoplasty: a prospective, randomized, double-blind, placebo-controlled study.
abstract: OBJECTIVE
  We compared the efficacy of intravenous lornoxicam vs. dipyrone in patient-controlled analgesia for postoperative analgesia.
  
  
  METHODS
  The study included 105 patients who had undergone elective septorhinoplasty after receiving general anaesthesia. Patients were divided into three groups to receive lornoxicam (24 mg day(-1)), dipyrone (5 g day(-1)) or placebo. Pain was evaluated using a 0-100 mm visual analogue scale at 2, 4, 6, 8, 12, 16, 20 and 24 h postoperatively. Pethidine (1 mg kg(-1)) was administered intramuscularly to patients requiring rescue analgesia. Pethidine requirements were recorded during the first 24 h postoperatively, and treatment-related adverse effects were noted.
  
  
  RESULTS
  Postoperative pain scores were significantly lower with lornoxicam compared with dipyrone at 8 h (P = 0.016). No significant differences regarding pain scores at 2, 4, 6, 12, 16, 20 and 24 h were found. Significantly fewer patients in the lornoxicam group required rescue analgesics (vs. dipyrone, P = 0.046; vs. placebo, P = 0.001); fewer patients in the dipyrone group required rescue analgesics compared with placebo (P = 0.008). Significantly fewer patients in the lornoxicam group had nausea (vs. dipyrone, P = 0.022; vs. placebo, P = 0.006); no significant differences were found between the other two groups. Antiemetic use was significantly lower in the lornoxicam group (vs. dipyrone, P = 0.002; vs. placebo, P = 0.001).
  
  
  CONCLUSIONS
  Lornoxicam has better tolerability and is a more effective analgesic than dipyrone when administered by patient-controlled analgesia for postoperative analgesia after septorhinoplasty.
authors.affiliation: Baskent University, Faculty of Medicine, Department of Otolaryngology, Ankara, Turkey. mesutsenertr@yahoo.co.uk
authors.forename: M
authors.initials: M
authors.lastname: Sener
authors.forename: C
authors.initials: C
authors.lastname: Yilmazer
authors.forename: I
authors.initials: I
authors.lastname: Yilmaz
authors.forename: E
authors.initials: E
authors.lastname: Caliskan
authors.forename: A
authors.initials: A
authors.lastname: Donmez
authors.forename: G
authors.initials: G
authors.lastname: Arslan
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods / Q000706:statistics & numerical data*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004177:Dipyrone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008614:Meperidine / Q000008:administration & dosage; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery*; D010147:Pain Measurement / Q000379:methods / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000188:drug therapy*; D010894:Piroxicam / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced / Q000517:prevention & control; D011446:Prospective Studies; D012225:Rhinoplasty; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010894:Piroxicam; D004177:Dipyrone; D008614:Meperidine; C059451:lornoxicam