The Effect of Preemptive Lornoxicam, Paracetamol and Paracetamol Lornoxicam Combinations on the Quality of Patient-Controlled Analgesia After Abdominal Surgery

Abstract

Anahtar KelimelerAnaljezi; Hasta-Kontrollü; Lornoksikam; Parasetamol; Fentanil Abstract Aim: We investigated total fentanyl dose, its side effects and the quality of Patient Controlled Analgesia (PCA) using preemptive paracetamol, lornoxicam and their combination after abdominal surgery. Material and Method: After approval of the Hospital Ethic Committee of Atatürk University, Erzurum, Turkey, The study included 120 ASA I or II, patients aged between 18 to 70 years, scheduled to undergo elective abdominal surgery (midline incision surgery). Patients were randomly divided into four groups. In all cases, anesthesia was induced with 2mg/kg propofol and 0.6mg/kg rocuronium. Anesthesia was maintained by using 1-1.5% sevoflurane in 60% 40% nitrous oxide -O2. Group control (Group C, n=30): received intravenous (i.v.) fentanyl through Patient Controlled Analgesia (PCA) Group Lornoxicam (Group L, n=30): a one-time 8mg dose of i.v. lornoxicam was added, which was completed approximately 30 minutes before intubation.; Group paracetamol (Group P, n=30): received 1g i.v. paracetamol before intubation, followed by every 6 hours for a total of four times. Group lornoxicam and paracetamol (Group PL, n=30): received 8mg i.v. lornoxicam before intubation, and 1g i.v. paracetamol before intubation every 6 hours for a total of 4 times. During the postoperative 2, 4, 8, 12 and 24 hours, visual analogue scale (VAS), sedation, and nausea-vomiting scores, patient satisfaction, incidence of side effects and total amount of fentanyl used were recorded. Results: Total postoperative fentanyl consumption was significantly higher in GC than of the other groups. At 2, 8, 12, 24. hours, fentanyl consumption was found to be significantly lower in GL than that in GC. In GPL, fentanyl consumption was significantly lower than in GC at all time points. Discussion: We observed that preemptive 8 mg lornoxicam decreased PCA fentanyl consumption but a combination of lornoxicam and paracetamol was not superior to lornoxicam alone.