PMID- 24672117
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140327
LR  - 20211021
IS  - 0011-393X (Print)
IS  - 0011-393X (Linking)
VI  - 66
IP  - 2
DP  - 2005 Mar
TI  - Comparison of the effects of lornoxicam versus diclofenac in pain management 
      after cardiac surgery: A single-blind, randomized, active-controlled study.
PG  - 107-16
LID - 10.1016/j.curtheres.2005.04.001 [doi]
AB  - BACKGROUND: Inadequate pain management after cardiac surgery may result 10 in 
      increased morbidity and length of hospital stay. Although opioids are the 
      mainstay of postoperative analgesia, nonsteroidal anti-inflammatory drugs 
      (NSAIDs) may be used instead to avoid the adverse effects (AEs) associated with 
      opioids. Lornoxicam is a newly developed NSAID, the use of which is increasing. 
      However, lornoxicam has not been studied for use in pain management after cardiac 
      surgery. OBJECTIVE: The objective of this study was to compare the efficacy and 
      tolerability 10 of lornoxicam and diclofenac sodium, an NSAID well established 
      for use in pain management after major surgery, in pain management after coronary 
      artery bypass grafting (CABG). METHODS: This single-blind, randomized, 
      active-controlled study was conducted 10 at the Gaziantep University Hospital, 
      Gaziantep, Turkey. Adult patients scheduled to undergo valve or CABG surgery for 
      the first time were included. Patients were premedicated with diazepam 10 mg PO 
      at 10 PM on the evening before surgery. General anesthesia was induced using 
      fentanyl, midazolam, and propofol, and maintained using fentanyl and isoflurane 
      in pure oxygen. After extubation and when they stated that they felt pain, 
      patients were randomly assigned to 1 of 2 treatment groups: lornoxicam 8 mg IM 
      q8h or diclofenac 75 mg IM q12h, for 48 hours. Meperidine 1 mg/kg IM was given 
      for additional analgesia when needed (rescue medication). Pain relief was 
      assessed using an I1-point visual analog scale (0 = no pain to 10 = worst pain 
      imaginable) immediately before the first injection (baseline), and at 15 and 30 
      minutes and 1, 2, 3, 4, 6, 12, 18, 24, and 48 hours after the first injection. 
      Sedation was assessed using a 5-point scale (0 = awake and alert to 4 = deep 
      sedation) at the same time points. Tolerability was assessed by monitoring of AEs 
      using patient interview and laboratory analyses. RESULTS: Forty patients were 
      enrolled in the study (30 men, 10 women; 10 mean [SD] age, 54.4 [11.1 ] years; 20 
      patients per treatment group). The demographic and clinical characteristics and 
      mean baseline pain relief scores were statistically similar between the 2 
      treatment groups. The mean pain relief scores at 15 and 30 minutes were 
      statistically similar to baseline values in the 2 treatment groups. However, the 
      mean pain relief scores at >/=1 hour after the first injection were significantly 
      lower compared with baseline values (both groups, P < 0.05 at time points >/=1 
      hour). No significant between-group differences in mean pain relief scores were 
      found at any time point. The overall mean pain relief scores were statistically 
      similar between the 2 treatment groups. The mean sedation scores were 
      significantly higher at 30 minutes, 1 hour, and 2 hours after the first injection 
      in the diclofenac group compared with the lornoxicam group (all, P < 0.05). No 
      AEs were observed. The need for rescue medication was statistically similar 
      between the 2 treatment groups (lornoxicam, 2 patients; diclofenac, 3 patients). 
      CONCLUSIONS: In this study of adult patients who underwent CABG, the efficacy 10 
      of lornoxicam and diclofenac were similar in postoperative pain management. Both 
      study drugs were well tolerated.
FAU - Daglar, Bahadir
AU  - Daglar B
AD  - Department of Cardiovascular Surgery, School of Medicine, Gaziantep 
      University,Gaziantep, Turkey.
FAU - Kocoglu, Hasan
AU  - Kocoglu H
AD  - Department of Anesthesiology, School of Medicine, GaziantepUniversity, Gaziantep, 
      Turkey.
FAU - Adnan Celkan, M
AU  - Adnan Celkan M
AD  - Department of Cardiovascular Surgery, School of Medicine, Gaziantep 
      University,Gaziantep, Turkey.
FAU - Goksu, Sitki
AU  - Goksu S
AD  - Department of Anesthesiology, School of Medicine, GaziantepUniversity, Gaziantep, 
      Turkey.
FAU - Kazaz, Hakki
AU  - Kazaz H
AD  - Department of Cardiovascular Surgery, School of Medicine, Gaziantep 
      University,Gaziantep, Turkey.
FAU - Kayiran, Celalettin
AU  - Kayiran C
AD  - Department of Cardiovascular Surgery, School of Medicine, Gaziantep 
      University,Gaziantep, Turkey.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Curr Ther Res Clin Exp
JT  - Current therapeutic research, clinical and experimental
JID - 0372621
PMC - PMC3964581
OTO - NOTNLM
OT  - cardiac surgery
OT  - diclofenac
OT  - lornoxicam
OT  - postoperative analgesia
EDAT- 2005/03/01 00:00
MHDA- 2005/03/01 00:01
PMCR- 2005/03/01
CRDT- 2014/03/28 06:00
PHST- 2005/01/27 00:00 [accepted]
PHST- 2014/03/28 06:00 [entrez]
PHST- 2005/03/01 00:00 [pubmed]
PHST- 2005/03/01 00:01 [medline]
PHST- 2005/03/01 00:00 [pmc-release]
AID - S0011-393X(05)00039-1 [pii]
AID - 10.1016/j.curtheres.2005.04.001 [doi]
PST - ppublish
SO  - Curr Ther Res Clin Exp. 2005 Mar;66(2):107-16. doi: 
      10.1016/j.curtheres.2005.04.001.