The analgesic efficacy of preoperative versus postoperative lornoxicam in varicocele repair.
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.
Inanoglu
Kerem
K
Department of Anaesthesiology and Reanimation, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey. kinanoglu@mku.edu.tr
Gorur
Sadik
S
Akkurt
Cagla Ozbakis
CO
Guven
Oguz E
OE
Kararmaz
Alper
A
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*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D010894:Piroxicam; D012965:Sodium Chloride; C059451:lornoxicam