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Infiltration with ropivacaine plus lornoxicam reduces postoperative pain and opioid consumption

[L’infiltration avec de la ropivacaïne, plus du lornoxicam, réduit la douleur postopératoire et la consommation d’opioïdes]

Beyhan Karamanlioglu, MD^*, Alparslan Turan, MD^*, Dilek Memis, MD^*, Gaye Kaya, MD^*, Sanem Ozata, MD^* and Mevlut Ture, MD

^* From the Departments of Anesthesiology, and
Biostatistics, Trakya University, Medical Faculty, Edirne, Turkey.

Address correspondence to: Dr. Beyhan Karamanlioglu, Trakya Üniversitesi Tp Fakültesi, Anesteziyolojive Reanimasyon AD, 22030, Edirne, Turkey. Fax: +90 284 235 80 96; E-mail: beykar{at}mynet.com

Purpose: To compare efficacy and patient outcome of wound infiltration with ropivacaine, lornoxicam, or their combination for control of pain following thyroid surgery.

Methods: Eighty patients underwent thyroid surgery were randomly assigned to one of four groups. Before skin closure, local tissues were infiltrated with 12 mL saline in Group S, with 10 mL of ropivacaine 0.75% plus 2 mL saline in Group R, with 2 mL of lornoxicam (8 mg) plus 10 mL saline in Group L, and with 10 mL ropivacaine 0.75% plus 2 mL lornoxicam (8 mg) in Group RL. Pain scores, total and incremental meperidine con-eight, 12, 18, and 24 hr postoperatively. Time to first analgesic requirement, patient satisfaction, and duration of hospital stay were also compared after surgery.

Results: The pain scores in Group RL were significantly lower in the first 12 hr than in Group S, and in the first four hours than in Groups R and L (P < 0.01). The time to first analgesic requirement was significantly longer (14.8 ± 8.4 hr vs 5.9 ± 5.2 hr; P < 0.01), the total pethidine consumption was significantly less than Group S (34.0 ± 33.0 mg vs 78.0 ± 29.8 mg; P<0.001), return of gastrointestinal function, ambulation time, length of hospital stay (P < 0.05) were significantly shorter, and patient satisfaction (P < 0.01) was significantly better in Group RL than in Group S (P < 0.05).

Conclusion: Wound infiltration with ropivacaine 0.75% plus lornoxicam 8 mg combination improved postoperative pain control and patient comfort, and decreased the need for opioids than the use of either drug alone.

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