Perioperative dexketoprofen or lornoxicam administration for pain management after major orthopedic surgery: a randomized, controlled study.
OBJECTIVE
Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended for multimodal postoperative pain management. The purpose of this study was to evaluate the postoperative pain relief and opioid-sparing effects of dexketoprofen and lornoxicam after major orthopedic surgery.


METHODS
After obtaining ethical committee approval and informed consent, 120 patients undergoing elective hip or knee replacement under general anesthesia were randomized to receive two intravenous injections of 50 mg dexketoprofen (GD), 8 mg lornoxicam (GL) or saline as placebo (GP) intravenously. Postoperatively, patient-controlled analgesia (PCA) morphine was started as a 0.01 mg.kg-1 bolus dose, with lockout time of 10 minutes without continuous infusion. Pain assessment was made using the Visual Analogue Scale (VAS) at rest or during movement at postoperative 1, 2, 4, 6, 8, 12, and 24 hours.


RESULTS
The three groups were similar in terms of age, gender, American Society of Anesthesiologists (ASA) class, number of patients who underwent hip or knee surgery, weight, height, and operation duration. Patients in GD and GL demonstrated significantly reduced pain scores at rest and active motion compared to GP, with lower scores in the dexketoprofen group. Patients in GD and GL used significantly less morphine in the postoperative period compared to GP. The total morphine consumption of patients in GD was lower than in GL.


CONCLUSIONS
Intravenous application of 50 mg dexketoprofen twice a day and 8 mg lornoxicam twice a day improved analgesia and decreased morphine consumption following major orthopedic surgery. When the two active drugs were compared, it was found that dexketoprofen was superior to lornoxicam in terms of analgesic efficacy and opioid consumption.
Department of Anesthesiology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.
Nükhet
N
Sivrikoz
Department of Anesthesiology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.
Kemalettin
K
Koltka
Department of Anesthesiology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.
Ece
E
Güresti
Department of Anesthesiology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.
Mehmet
M
Büget
Department of Anesthesiology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.
Mert
M
Sentürk
Department of Anesthesiology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.
Süleyman
S
Özyalçın
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007660:Ketoprofen / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D019990:Perioperative Care; D010894:Piroxicam / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011446:Prospective Studies; D016896:Treatment Outcome; D014325:Tromethamine / Q000008:administration & dosage*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D014325:Tromethamine; D010894:Piroxicam; D007660:Ketoprofen; C059451:lornoxicam; C118296:dexketoprofen trometamol