A Comparative Study of Ketorolac with Lornoxicam as Pre-emptive Analgesics in Patients Who were Undergoing Elective Abdominal Surgery under General Anaesthesia
Girish Babu Narasimha Murthy, Girish M. Bengalorkar, Ravi Madhusudhana
Associate Professor, Anaesthesiology,
R.L. Jalappa Hospital & Research Center
Sri Devaraj Urs Medical College, Tamaka, Kolar- 563 101
Introduction: NSAIDs and opioids are the drugs which are commonly used in the post-operative pain management. The purpose of the present study was to determine the pre-emptive analgesic effects of lornoxicam, and ketorolac and the reduction in the opioid consumption post operatively.
Materials and Methods: Ninety patients of ASA class I-II, who were undergoing abdominal surgeries under general anaesthesia, were assigned in a randomized manner into three groups. Group K received a single IV injection of Ketorolac 30 mg (1ml), Group L received a single IV injection of lornoxicam 8mg (1ml) and Group P received IV saline (1ml) 1 hour before surgery.
Results: The post-operative pain scores were evaluated at 2, 4, 8, 12 and 24 hours by using a Visual Analogue Scale (VAS). The time taken to administer the first dose of rescue analgesic was significantly delayed in the Groups K and L as compared to Group P (291 min for gp K, 302 min for gp L as compared to P of 107 min, p<0.001). The pain scores between the Groups K and L were significantly lower as compared to those in Group P at 2,4, 8 ,12 and 24 hours. The twenty four hour analgesic consumption was significantly lower in Groups K and L as compared to that in Group P (p<0.05). The 24 hr total opioid consumption was 47 % and 54 % less in the lornoxicam and the ketorolac groups as compared to that in the placebo group. The degree of satisfaction with the post-operative pain management was excellent in 15 % and 40 % of the patients in Groups K and L respectively. Nausea and vomiting were seen more in Group P due to increased tramadol consumption.
Conclusion: Lornoxicam decreased the VAS score and the need for opioids as compared to ketorolac, by its pre-emptive administration. It was found to be an equally effective analgesic like ketorolac in abdominal surgeries.
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