effect of lornoxicam with intravenous regional anesthesia on intraoperative and postoperative analgesia for forearm surgery

ABSTRACT

To evaluate the effect of lornoxicam added to lignocaine for intravenous regional anesthesia [IVRA]. Prospective, randomized, double-blind controlled study. King Fahd Hospital, University of Dammam, Saudi Arabia. Forty patients scheduled for upper limb surgery under IVRA were randomly allocated into two groups [20 patients per group] during the period from August 2010 to November 2011. All patients received 4 mg/kg body weight lignocaine in 40 ml solution plus 3 ml of study solution containing either normal saline [control group] or lornoxicam 12 mg [IVRA- L group]. Hemodynamic changes, sensory and motor block onset time, intraoperative and postoperative analgesia and total analgesic drug required in first 24 hours were observed. Onset of sensory and motor block, requirement of intraoperative fentanyl, incidence of tourniquet pain, requirement of postoperative analgesia in terms of paracetamol consumption. Patients who received the lornoxicam [IVRA-L group] had earlier onset of sensory and motor block [p < 0.001] and less requirement of intraoperative fentanyl [p < 0.001]. Lornoxicam group patients tolerated tourniquet pain better [p < 0.001] and had better postoperative analgesia for first 24 hours [p < 0.0005]. Lornoxicam 12 mg is a beneficial addition to IVRA. It shortens the sensory and motor block onset time and increases the intraoperative and postoperative analgesia without any side effects. We observed that among nonsteroidal anti inflammatory drugs [NSAIDs], lornoxicam is a very effective and safe adjunct to lignocaine for IVRA in upper limb surgery