Comparative study of different doses and routes of administration of lornoxicam for peri-operative analgesia in patients undergoing intravenous regional anesthesia for minor upper arm surgery

The use of perioperative NSAIDs has become popular in operation ranging from minor outpatient to major inpatient surgery. A systemic review suggested that NSAIDs have the most to offer as adjuncts to intravenous regional anesthesia. Lornoxicam has demonstrated clinical efficacy in relieving pain, through different routes of administrations, oral, IM, IV, and local infiltration. In this study comparison of different doses and routes of administration of Lornoxicam for peri-operative analgesia in patients undergoing intravenous regional anesthesia for minor upper arm surgery was done. 60 patients ASA 1 and 2 undergoing minor upper limb surgeries were studied Patients were randomly divided into six groups; Group I: Total volume of 40ml of pre-prepared Local intravenous solution mixed with 8mg of Lornoxicam. Group 2: Total volume of 40ml of pre-prepared Local intravenous solution mixed with 16mg of Lornoxicam. Group 3: Total volume of 40ml of pre-prepared Local intravenous solution plus Lornoxicam 8mg intramuscular. Group 4: Total volume of 40ml of pre-prepared Local intravenous solution plus Lornoxicam 16mg intramuscular. Group 5: Total volume of 40ml of pre-prepared Local intravenous solution plus Lornoxicam 8mg intravenously. Group 6: Total volume of 40ml of pre-prepared Local intravenous solution plus Lornoxicam 16mg intravenously. Better qualities of block, less tourniquet pain, and better quality of postoperative analgesia were found in groups 1, 2 that had lornoxicam combined with lidocaine compared with other groups used lornoxicam intravenously or intramuscular [p<0.05]. Moreover, using lornoxicam 16mg proved to be better than lornoxicam 8mg when combined with total intravenous solution [p<0.05]. Lornoxicam used in the local intravenous solution gave better quality of intraoperative condition and postoperative analgesia without increase in the incidence of side effects compared with lornoxicam used intramuscularly or intravenously. Also lornoxicam 16mg provide better intraoperative analgesia compared to lornoxicam 8mg when both were used locally with local intravenous regional analgesia