[The effects of lornoxicam in preventing remifentanil-induced postoperative hyperalgesia].
OBJECTIVE
Intraoperative remifentanil administration results in acute opioid tolerance that is manifested by increased postoperative pain, opioid requirement and specifically peri-incisional hyperalgesia. The aim of this study was to investigate the effect of lornoxicam in preventing remifentanil-induced hyperalgesia.


METHODS
Patients were randomly divided into two groups. Fifteen minutes before surgery, saline solution was given to the patients in group I and 16 mg i.v. Lornoxicam in group II. Anesthesia was induced with 1 microg/kg remifentanil combined with 1.5-2 mg/kg propofol and maintained with 0.5 MAC desflurane and 0.4 microg/kg/dk remifentanil in both groups. Desflurane concentration was titrated according to autonomic responses. All patients were given i.v. 0.15 mg/kg morphine 30 min before the end of surgery. At the end of surgery, patients received morphine i.v. Via a PCA (Patient Controlled Analgesia) device. Pain score, morphine demand and delivery were assessed at 2, 4, 6, 12 and 24 h after surgery. Total morphine consumption was recorded for 24-48 h. Peri-incisional hyperalgesia was assessed by measuring pain threshold to pressure using an algometer before operation and at 24-48 h postoperatively.


RESULTS
The pain scores and cumulative morphine consumption were significantly lower in the lornoxicam group when compared with the control group (p<0.05). Pain thresholds were significantly less at 24-48 h postoperatively in the control group than in the lornoxicam group. No significant difference was observed in side effects (p>0.05).


CONCLUSIONS
Lornoxicam administered preemptively prevented remifentanil-induced hyperalgesia.
Tuncer
Sema
S
Department of Algology, Selcuk University, Meram Faculty of Medicine, Konya, Turkey. tuncersema@hotmail.com.
Yalçin
Naime
N
Reisli
Ruhiye
R
Alper
Yosunkaya
Y
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000517:prevention & control*; D007044:Hysterectomy; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D010880:Piperidines / Q000008:administration & dosage / Q000627:therapeutic use*; D011300:Preoperative Care; D015742:Propofol / Q000627:therapeutic use; D000077208:Remifentanil; D012684:Sensory Thresholds / Q000187:drug effects / Q000502:physiology
D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010880:Piperidines; D009020:Morphine; D000077208:Remifentanil; D015742:Propofol