Postoperative analgesic effects of lornoxicam after thyroidectomy: a placebo controlled randomized study

The purpose of the present study was to determine the postoperative analgesic effects of lornoxicam and the reduction in tramadol consumption. Fourty patients of ASA class I-II, 18-70 years of age, undergoing thyroidectomy were assigned in a randomized manner into two groups: GroupL received 8 mg of lornoxicam i.v. at the end of the operation followed by 8 mg of lornoxicam b.i.d., i.v. for 24 hours postoperatively. GroupP received 4 ml of saline solution i.v. at the end of the operation and the same amount b.i.d., i.v. for 24 hours postoperatively. The requirements for supplemental analgesics were recorded at 0-6, 6-12 and 12-24 hour intervals. Postoperative pain scores were evaluated at 15th min. and 1, 2, 4, 6, 8, 12, 18 and 24th hours using Visual Analogue Scale (VAS). The time to first analgesic requirement was significantly longer in GroupL compared to GroupP (101.7 vs 37.9 min, p<0.001). Pain scores were significantly lower in GroupL compared to GroupP at 15th min, 1, 8 ,12 and 18th hours. Twenty four hour analgesic consumption was significantly lower in GroupL compared to GroupP (p<0.05). The amount of tramadol consumed in GroupL was 60% lower compared to GroupP (100 mg and 250 mg (mean), respectively). 100% of the patients in GroupL and 60 % of the patients in GroupP needed supplemental analgesics. The degree of satisfaction with postoperative pain management was excellent in 95 % of patients in GroupL and 25 % of patients in GroupP. Eighteen patients in GroupP and 9 patients in GroupL had nausea (p=0.002), and fifteen patients in GroupP and 8 patients in GroupL had vomiting (p=0.025). Lornoxicam decreased the opioid need, the incidence of nausea and vomiting and postoperative pain scores. Moreover, it was observed that the time needed for the first analgesic requirement was prolonged following thyroidectomies.