Intravenous Administration of Lornoxicam, a New NSAID, and Pethidine for Postoperative Pain

Summary

In order to determine the efficacy of lornoxicam in postoperative pain, an observer-blind, placebo-controlled, multiple-dose study was conducted. 80 patients (26 female, 54 male, aged 24 to 61 years) with moderate to severe pain after laminectomy were randomised to receive lornoxicam 4 or 8mg intravenously, pethidine 50mg intravenously or isotonic distilled water (placebo) at their first request for analgesia. Efficacy was determined by the time between the first dose and the first request for remedication, pain intensity differences from baseline (PID) measured by verbal rating scales, the total number of doses required over 24 hours, and patients’ overall impression of efficacy. The median time to remedication was 35 minutes for placebo, 38 minutes for lornoxicam 4mg, 100 minutes for lornoxicam 8mg and 75 minutes for pethidine. Mean PID values were −0.5 for placebo, −0.6 and −0.8 for lornoxicam 4 and 8mg, respectively, and −0.7 for pethidine. Patients receiving lornoxicam 8mg required a mean of 2.6 doses over 24 hours, whilst other groups required 3 doses. There was a consistent trend towards superior efficacy with lornoxicam 8mg and pethidine 50mg, followed by lornoxicam 4mg, then placebo; this was reflected in patients’ overall ratings of ‘good’ for lornoxicam 8mg and pethidine, ‘good to fair’ for lornoxicam 4mg, and ‘fair’ for placebo. Two patients in the lornoxicam 8mg group and 4 in the pethidine group reported adverse events, mostly mild to moderate nausea. One patient in the pethidine group discontinued treatment because of bradycardia. In summary, lornoxicam 8mg intravenously was as effective as pethidine 50mg intravenously in relieving moderate to severe postlaminectomy pain, and had few adverse events.