title: The analgesic efficacy of preoperative versus postoperative lornoxicam in varicocele repair.
abstract: OBJECTIVE
  To determine whether intravenous injection of lornoxicam 30 minutes before skin incision provides better pain relief after varicocelectomy than postoperative administration of lornoxicam.
  
  
  METHODS
  Prospective, double-blind, randomized clinical investigation.
  
  
  METHODS
  Operating room and postoperative recovery area.
  
  
  METHODS
  44 ASA physical status I and II adult male patients undergoing varicocelectomy.
  
  
  METHODS
  Patients were randomized either to receive 8 mg lornoxicam infusion 30 minutes before skin incision, followed by saline infusion immediately after skin closure (group 1), or to receive the identical injections but in reverse order (group 2). All patients received local anesthesia with bupivacaine.
  
  
  METHODS
  Postoperative pain scores were evaluated hourly for the first 8 hours after surgery, then at 12, 16, 20, and 24 hours after surgery, using a 10-cm visual analog scale. Time to first analgesic request and patients' global assessments also were recorded.
  
  
  RESULTS
  Patients in group 1 reported significantly lower pain scores (P < 0.05) at all time intervals except at 24 hours and better global assessment (P = 0.001) than did group 2. There were significantly fewer patients in the preemptive group than group 2 who required rescue analgesic within the first 24 hours (0% vs 22.7%; P = 0.024). Mean time to first analgesic request was also significantly longer in the preemptive group (P = 0.001).
  
  
  CONCLUSIONS
  Intravenous lornoxicam administered before surgery has a better analgesic effect for varicocelectomy than when administered postoperatively.
authors: Department of Anaesthesiology and Reanimation, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey. kinanoglu@mku.edu.tr
authors: Kerem
authors: K
authors: Inanoglu
authors: Sadik
authors: S
authors: Gorur
authors: Cagla Ozbakis
authors: CO
authors: Akkurt
authors: Oguz E
authors: OE
authors: Guven
authors: Alper
authors: A
authors: Kararmaz
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000379:methods; D000698:Analgesia / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D004311:Double-Blind Method; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D010147:Pain Measurement / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control; D010894:Piroxicam / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011182:Postoperative Care / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome; D014646:Varicocele / Q000601:surgery*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D010894:Piroxicam; D012965:Sodium Chloride; C059451:lornoxicam