Infiltration with ropivacaine plus lornoxicam reduces postoperative pain and opioid consumption

Abstract

Purpose:To compare efficacy and patient outcome of wound infiltration with ropivacaine, lornoxicam, or their combination for control of pain following thyroid surgery. Methods:Eighty patients underwent thyroid surgery were randomly assigned to one of four groups. Before skin closure, local tissues were infiltrated with 12 mL saline in Group S, with 10 mL of ropivacaine 0.75% plus 2 mL saline in Group R, with 2 mL of lornoxicam (8 mg) plus 10 mL saline in Group L, and with 10 mL ropivacaine 0.75% plus 2 mL lornoxicam (8 mg) in Group RL. Pain scores, total and incremental meperidine consumption were recorded at 30 min, one, two, three, four, six, eight, 12, 18, and 24 hr postoperatively. Time to first analgesic requirement, patient satisfaction, and duration of hospital stay were also compared after surgery. Results:The pain scores in Group RL were significantly lower in the first 12 hr than in Group S, and in the first four hours than in Groups R and L (P < 0.01). The time to first analgesic requirement was significantly longer (14.8 ± 8.4 hr vs 5.9 ± 5.2 hr; P < 0.01), the total pethidine consumption was significantly less than Group S (34.0 ± 33.0 mg vs 78.0 ± 29.8 mg; P<0.001), return of gastrointestinal function, ambulation time, length of hospital stay (P < 0.05) were significantly shorter, and patient satisfaction (P < 0.01) was significantly better in Group RL than in Group S (P < 0.05). Conclusion: Wound infiltration with ropivacaine 0.75% plus lornoxicam 8 mg combination improved postoperative pain control and patient comfort, and decreased the need for opioids than the use of either drug alone. (14,8 ± 8,4 h vs 5,9 ± 5,2 h ; P < 0,01), la consommation totale de péthidine a été plus basse que dans le groupe S (34,0 ± 33,0 mg vs 78,0 ± 29,8 mg ; P < 0,001) Objectif

Comparison Of Analgesic Effects Of Intraperitoneal Lornoxicam And Ropivacaine Administration In Laparoscopic Cholecystectomy.

“…[48][49][50] This drug possesses anti-inflammatory activity that may further reduce pain when administered locally. [51,52] The reason of preferring ropivacain in our study is that it is a long-acting agent (6-12 hours), has less motor blockages and a less cardiotoxicity than bupivacain. [25] We have provided nearly total blocks by giving the local anesthetics agents to all regions that many surgical manipulation were applied, such as hepatoduodenal ligaman, gallbladder bed, subdiaphragmatic and subhepatic area.…”

Preoperative peritonsillar lornoxicam infiltration is not superior to intravenous lornoxicam for pain relief following tonsillectomy in adults

“…Wound infiltration with combined ropivacaine plus lornoxicam improved postoperative pain control and decreased opioid consumption compared with the application of either drug alone, suggesting a local effect. 19 Moreover, addition of lornoxicam to lidocaine 20 or prilocaine 21 in i.v. regional analgesia reduced pain scores, improved quality of the block and decreased the analgesic requirements.…”

Non-opioid strategies for acute pain management

“…Finally, wound infiltration with local anesthetics with or without the use of continuous infusions via sc catheters are being reassessed as tested recently by Karamanlioglu et al 19 …”