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
Correspondence
Ravi Madhusudhana Associate Professor, Anaesthesiology, R.L. Jalappa Hospital & Research Center Sri Devaraj Urs Medical College, Tamaka, Kolar- 563 101 Karnataka, India. Phone: +919845287591 E-mail: ravijaggu@hotmail.com
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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