Comparison of lornoxicam and fentanyl when added to lidocaine in intravenous regional anesthesia.
OBJECTIVE
In this study, our goal was to compare intraoperative and postoperative analgesic effects of lornoxicam and fentanyl when added to lidocaine Intravenous Regional Anesthesia (IVRA) in a group of outpatients who underwent hand surgery.


METHODS
This is a double blind randomized study. A total of 45 patients were included, randomized into three groups. Patients in Group I (L) received 3 mg.kg-1 of 2% lidocaine 40 mL; patients in Group II (LL) received 3 mg.kg-1 lidocaine 38 mL + 2 mL lornoxicam; patients in Group III (LF) received 3 mg.kg-1 lidocaine 38 mL + 2 mL fentanyl. Our primary outcome was fi rst analgesic requirement time at postoperative period.


RESULTS
Lornoxicam added to lidocaine IVRA increased the sensory block recovery time without increasing side effects and increased fi rst analgesic requirement time at the postoperative period when compared to lidocaine IVRA (p < 0.001, p < 0.001 respectively) and fentanyl added to lidocaine IVRA (p < 0.001, p < 0.001 respectively). In addition, we also found that fentanyl decreased tourniquet pain (p < 0.01) when compared to lidocaine but showed similar analgesic effect with lornoxicam (p > 0.05) although VAS scores related to tourniquet pain were lower in fentanyl group. Lornoxicam added to lidocaine IVRA was not superior to lidocaine IVRA in decreasing tourniquet pain.


CONCLUSIONS
Addition of fentanyl to lidocaine IVRA seems to be superior to lidocaine IVRA and lornoxicam added to lidocaine IVRA groups in decreasing tourniquet pain at the expense of increasing side effects. However, lornoxicam did not increase side effects while providing intraoperative and postoperative analgesia. Therefore, lornoxicam could be more appropriate for clinical use.
Ege University, School of Medicine, Department of Anesthesiology and Reanimation, Izmir, Turkey. nezihsertoz@mynet.com
Nezih
N
Sertoz
Nazan
N
Kocaoglu
Hilmi Ö
HÖ
Ayanoğlu
D000293:Adolescent; D000328:Adult; D000698:Analgesia; D000765:Anesthesia, Conduction; D000771:Anesthesia, Intravenous; D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D004311:Double-Blind Method; D005283:Fentanyl; D006801:Humans; D007430:Intraoperative Care; D008012:Lidocaine; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D010894:Piroxicam / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011182:Postoperative Care; D055815:Young Adult
D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010894:Piroxicam; D008012:Lidocaine; C059451:lornoxicam; D005283:Fentanyl