title: Comparison of lornoxicam and fentanyl when added to lidocaine in intravenous regional anesthesia.
abstract: 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 3mg.kg(-1) of 2% lidocaine 40 mL; patients in Group II (LL) received 3mg.kg(-1) lidocaine 38 mL + 2 mL lornoxicam; patients in Group III (LF) received 3mg.kg(-1) lidocaine 38 mL + 2 mL fentanyl. Our primary outcome was first analgesic requirement time at postoperative period.
  
  
  RESULTS
  Lornoxicam added to lidocaine IVRA increased the sensory block recovery time without increasing side effects and increased first 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.
authors.affiliation: MD; Ege University, School of Medicine, Department of Anesthesiology and Reanimation, Izmir, Turkey. Electronic address: nezihsertoz@mynet.com.
authors.forename: Nezih
authors.initials: N
authors.lastname: Sertoz
authors.affiliation: MD; Kırşehir State Hospital. Department of Anesthesiology and Reanimation, Izmir, Turkey.
authors.forename: Nazan
authors.initials: N
authors.lastname: Kocaoglu
authors.affiliation: MD Professor; Marmara University, School of Medicine, Department of Anesthesiology and Reanimation, Istanbul, Turkey.
authors.forename: Hilmi Ö
authors.initials: HÖ
authors.lastname: Ayanoğlu
mesh_terms: D000328:Adult; D000368:Aged; D000771:Anesthesia, Intravenous / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D004311:Double-Blind Method; D004338:Drug Combinations; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008875:Middle Aged; D010894:Piroxicam / Q000008:administration & dosage / Q000031:analogs & derivatives*; D064232:Visual Analog Scale
chemical_list: D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D010894:Piroxicam; D008012:Lidocaine; C059451:lornoxicam; D005283:Fentanyl
keywords: Anesthesia; Anesthetics; Conduction; Fentanyl; Lidocaine; Local; Piroxicam/lornoxicam.