title: Intravenous lornoxicam is more effective than paracetamol as a supplemental analgesic after lower abdominal surgery: a randomized controlled trial.
abstract: BACKGROUND
  The aim of this prospective, randomized, double-blind study was to determine the more effective supplemental analgesic, paracetamol or lornoxicam, for postoperative pain relief after lower abdominal surgery.
  
  
  METHODS
  Sixty patients scheduled for lower abdominal surgery under general anesthesia were randomly allocated to receive either isotonic saline (control group), intravenous paracetamol 1 g every 6 h (paracetamol group), or lornoxicam 16 mg then 8 mg after 12 h (lornoxicam group). Additionally pain was treated postoperatively with morphine patient-controlled analgesia. Postoperative pain scores measured by the verbal pain score (VPS), morphine consumption, and the incidence of side effects were measured at 1, 2, 4, 8, 12, and 24 h postoperatively.
  
  
  RESULTS
  Morphine consumption at 12 and 24 h was significantly lower in the lornoxicam group (19.25 ± 5.7 mg and 23.1 ± 6.5 mg) than in the paracetamol group (23.4 ± 6.6 mg and 28.6 ± 7.6 mg). Both treatment groups had less morphine consumption than the control group (28.5 ± 5 mg and 38.1 ± 6.6 mg) at 12 and 24 h, respectively. Additionally, VPS was reduced in the paracetamol and the lornoxicam groups compared with the control group both at rest and on coughing. Further analysis revealed that VPS in the lornoxicam group was significantly lower than that in the paracetamol group only during coughing. Drug-related side effects were comparable in all groups.
  
  
  CONCLUSIONS
  Lornoxicam is superior to paracetamol for postoperative analgesia after lower abdominal surgery. However, paracetamol could be an alternative supplemental analgesic whenever an NSAID is unsuitable.
  
  
  BACKGROUND
  clinicaltrials.gov.identifier:NCT01564680.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Dammam University, Dammam, Saudi Arabia. hany.mowafi@gmail.com
authors.forename: Hany A
authors.initials: HA
authors.lastname: Mowafi
authors.forename: Ehab Abou
authors.initials: EA
authors.lastname: Elmakarim
authors.forename: Salah
authors.initials: S
authors.lastname: Ismail
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al-Mahdy
authors.forename: Abd Elhady
authors.initials: AE
authors.lastname: El-Saflan
authors.forename: Ayman S
authors.initials: AS
authors.lastname: Elsaid
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000082:Acetaminophen / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000700:Analgesics / Q000008:administration & dosage*; D013505:Digestive System Surgical Procedures; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy*; D010894:Piroxicam / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011446:Prospective Studies; D013519:Urogenital Surgical Procedures
chemical_list: D000700:Analgesics; D010894:Piroxicam; D000082:Acetaminophen; D009020:Morphine; C059451:lornoxicam