Efficacy and Tolerability of Lornoxicam versus Tramadol in Postoperative Pain

Abstract

This randomized double-blind study compared the analgesic efficacy and tolerability of intramuscular lornoxicam and tramadol in 76 patients with moderate to unbearable pain following arthroscopic reconstruction of the anterior cruciate ligament using the patella bone-tendon-bone technique. Patients receiving a single dose of lornoxicam 16 mg experienced significantly greater total pain relief than patients receiving tramadol 100 mg over the following 8 hours. Lornoxicam had greater analgesic efficacy than tramadol in patients with moderate baseline pain but was of equivalent efficacy in those with severe/unbearable baseline pain. Fewer patients in the lornoxicam group required rescue medication (58% vs. 77%, respectively). Patients' global impression of efficacy showed lornoxicam to be superior to tramadol with 82% and 49% of patients, respectively, rating treatment as good, very good, or excellent. Following multiple-dose administration of lornoxicam (8 mg tid) or tramadol (100 mg tid) for 3 days, efficacy profiles similar to those following a single dose were obtained. Thus, slightly fewer patients in the lornoxicam group required rescue medication, and patients' global impression of efficacy again favored lornoxicam. Adverse events were reported by 38 of the 76 patients and were mainly mild to moderate in severity. Significantly fewer patients reported one or more adverse events with lornoxicam than with tramadol (14 vs. 24, respectively). Thus, intramuscular lornoxicam offers a useful alternative to tramadol for the treatment of moderate to severe postoperative pain.

Is Lornoxicam Better Than Low-Dose Tramadol for Post-thyroidectomy Pain?

“…However, incidence of side effects was 60% in morphine group and 25% in lornoxicam group (p<0.05). Staunstrup et al [16] investigated the efficacy and tolerability of lornoxicam versus tramadol in postoperative pain. In their study, patients received a single dose of lornoxicam 16 mg and tramadol 100 mg.…”

“…However, the studies showed that lornoxicam does not increase the risk of bleeding in therapeutic dosage. [16][17][18] Krishna et al reported [19] no significant increase in post-tonsillectomy bleeding after NSAID administration. In our study, none of the patients had postoperative bleeding in any group.…”

Infiltration with ropivacaine plus lornoxicam reduces postoperative pain and opioid consumption

“…4,28 In the postoperative setting, lornoxicam has been well tolerated, with a tolerability profile similar to diclofenac 29 but superior to that of indomethacin. 5 The most frequent adverse effects were dizziness, abdominal pain, headache, and vomiting.…”

The synergistic antinociceptive effect of lornoxicam in combination with tramadol

“…High therapeutic potency is indicated in low doses, with a reduced risk of side eff ects (6)(7)(8). Preliminary research, which requires further confi rmation, suggest that lornoxicam may be a better alternative or adjunctive therapy to opioid analgesics in the treatment of moderate to severe pain (9,10). Studies have also shown that opioids may act in synergy with some NSAIDs, and that such combinations may have therapeutic benefi t in the clinical treatment of infl ammatory pain (11).…”