A Prospective Study Of Pre-Emptive Analgesia With Lornoxicam In Laparoscopic Appendicectomy Under General Anesthesia- A Randomized Controlled Trial

Abstract

Background and objectives ABSTRACT The post- operative period is an important part of the surgical experience and affects the recovery. Patients experience moderate to severe pain post- operatively. The most commonly used agents for the control of postoperative pain are parenteral NSAID’s and opioid analgesics. . The concept of pre-emptive analgesia suggests that the best post-operative pain management begins pre- operatively. Laparoscopic appendicectomy is a standard procedure that is routinely being performed for appendicitis. However most patients undergoing laparoscopic appendicectomy complain of pain at the port site preventing ambulation and delaying recovery. Lornoxicam is a newer NSAID belonging to the oxicam class. It has a strong analgesic and anti-inflammatory activity. The present study was conducted to study the pre-emptive analgesic efficacy of Lornoxicam in patients undergoing laparoscopic appendicectomy Methodology The present study was conducted in the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum between January 2011 to December 2011. A total of 66 patients undergoing laparoscopic appendicectomy were included in the study. These patients were randomized into two groups based on computer generated blocked random numbers into Group A ( Pre-emptive ) and Group B ( Placebo) . . IV Results In the present study, comparison of the pain scores at 3 hours post- operatively between the pre-emptive group ( Group A ) and placebo group ( Group B ) did not show any statistically significant reduction in the pain. p=0.5261. However there was statistically significant difference in the analgesic requirements between the two groups. The analgesic requirement for patients in Group B ( 39.39% ) was significantly higher as compared to patients in Group A ( 6.06% ) . p < 0.001. Assessment at post-operative 6 hours shows there was no statistically significant difference in the pain scores between Group A and Group B. p= 0.586 and also the analgesic requirement between the two groups were comparable. p= 0.056 At post-operative 10 hours there was no statistically significant difference in the pain scores between Group A and Group B. p= 0.555 Further there was no statistically significant reduction in the analgesic requirement between the patients in Group A and Group B at Post-operative 10 Hours. p= 0.573 Similarly, there was no statistically significant difference in the pain scores between Group A and Group B at post-operative 24 hours, p= 0.641; however, the analgesic requirement in Group A at 24 hours post-operatively was significantly lower than the analgesic requirement by patients in Group B. p< 0.001