NURTEN İNAN, NAMIK NEBİ ÖZCAN, SUNA AKIN TAKMAZ, AYŞE ÖZCAN, İpek ERDOĞAN, Bülent BALTACI

Efficacy of lornoxicam in postoperative analgesia after total knee replacement surgery

Total diz protezi operasyonları, postoperatif dönemde ciddi ağrı ile seyretmektedir. Opioidlerin önemli yan etkileri nedeni ile çoklu analjezi yöntemi bu yaşlı hasta grubunda daha uygundur. Lornoksikamın (32mg/48 saat) total morfin tüketimi ve yan etkiler üzerine olan etkisinin araştırıldığı bu çift kör, randomize, plasebo kontrollü çalışmamıza, total diz protezi ameliyatı geçirecek olan yaşlı hastalar dahil edildi. Postoperatif dönemde grup M (n=23) ve grup L ‘ye (n=23) morfin içeren hasta kotrollü analjezi uygulandı. Grup L’ye bu tedaviye ilave olarak 16 mg lornoksikam cerrahiden 15 dk önce, 8 mg lornoksikam da postoperatif 12. ve 24. saatlerde uygulandı. Morfin tüketimi postoperatif 2, 3, 6, 8, 24, 36 ve 48. saatlerde grup L de anlamlı olarak düşük bulundu (p

Anahtar Kelimeler:

Artroplasti, replasman, diz, Ağrı, ameliyat sonrası

Total diz protezi cerrahisinde postoperatif analjezi amacı ile kullanılan lornoksikamın etkinliği

In total knee replacement operation, patients have a severe pain in postoperative period. Because of side effects of opioids, multiple postoperative pain treatment regimens are more suitable in these elderly patients. In this double-blind, randomized, placebo controlled study, the effect of lornoxicam administration (32 mg/48 hour) on morphine consumption and drug-related side effects were investigated in elderly patients undergoing total knee replacement. Group M (n=23) and Group L (n=23) received morphine with patient controlled analgesia (PCA) device postoperatively. Additionally Group L received lornoxicam 16 mg iv 15 minutes before surgery and 8 mg at postoperative 12th and 24th hours. Morphine consumption in Group L were significantly lower than in Group M at 2, 3, 6, 8, 24, 36 and 48 postoperative hours (p<0.05). At the end of 48th hour mean total morphine consumptions (mean ± sd) for Group M and Group L were 63,70 ± 15,70 mg and 34,60 ± 16,32 mg, respectively. AUC (Area under the curve) Morphine 0-48h in Group M was 59 ±13 and in Group L was 30±13 (p<0.001). Incidence of side effects in Group M were 60 % and 25 % in Group L (p<0.05). In Group M, 8 patients (40%) experienced nausea and 3 (15 %) patients experienced itching where as in Group L, 3 patients (15 %) experienced nausea, 1 patient (5 %) itching, 1 patient (5 %) dry mouth. Lornoxicam administration in total knee replacement is associated with decreased morphine consumption for postoperative analgesia and fewer side effects.

Keywords:

Arthroplasty, Replacement, Knee, Pain, Postoperative,

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