Effect of pre-emptive analgesia with lornoxicam on pain and the expression of pselectin on platelet after modified radical mastectomy / 中国现代普通外科进展

ABSTRACT

Objective:To determine whether lornoxicam has a preemptive analgesic effect to the patients who undergo modified radical mastectomy.To study the effect of lonoxicam on platelet function and investigate the surface expression of p-selectin on platelet by a flow-cytometric assay.Methods:After obtaining a written informed consent from patients,sixty ASAⅠ-Ⅱpatients,aged 40-60 yr,weighted 40-60 Kg,who were scheduled for modified radical mastectomy were included in the study.All patients were randomly divided into two groups.Patients underwent breast surgery under general anesthesia,Group I was administered 16mgof lornoxicam iv.30 minutes prior to surgery,Group Ⅱ was administered 4 mL placebo.Two mL blood was drawn from a peripheral vein to analyze the surface expression of p-selectin on platelet,blood sample was collected at three time points:30 minutes prior to surgery,6h and 24h after surgery.Introoperative blood loss and the volume of drainage fluid 24h,48h,and 72h after surgery was documented;PONV and other side effects was recorded.The rescue analgesics was recorded.Result:Group I demonstrated reduced pain scores compared to Group Ⅱ at three specific time points;Great difference for the expression of p-selectin on platelet at certain time point in each group was noted,the postoperative express was higer than that of the preoperation;there were no difference for the expression of p-selectin on platelet between two groups.There were no difference in introoperative blood loss and the volume of drainage fluid between two groups;Great difference for the rescue analgesics was recorded,GroupⅡdemends more analgesics than GroupⅠ.The rate of PONV was similar between two groups,no other side effects were recorded.Conclusion:Lornoxicam administered preemptively appears to reduce pain scores after surgery,which can improve the quality of postoperative analgesia.Lornoxicam has no significant effect on platelet activation and aggregation with only one dose before surgery,there is no effect in the quality of blood coagulation.Lornoxicam may be safely used in perioperative period.