Comparison of efficacy and tolerability of tramadol with lornoxicam as post operative pain management by administering pre-emptively in patients undergoing elective gynecological surgery under regional subarachnoid block anesthesia

Abstract

ABSTRACT Objective: The purpose of the present study was to determine the pre-emptive analgesic effects of Tramadol and Lornoxicam. Materials and Methods: Fifty women of ASA (American society of anaesthesiologists) class I and II, who were undergoing gynaecological surgeries under Regional subarachinoid block anaesthesia, were assigned in a randomized manner into two groups. Group T received a single IV injection of Tramadol 50mg (1ml), Group L received a single IV injection of Lornoxicam 8mg(1ml) 1hour before surgery. Results: The post-operative pain scores were evaluated at 2, 4, 8, 12 and 24 hours by using a Visual Analogue Scale (VAS). The post operative VAS scores were significant (p<0.001) within the groups. The VAS score at 24hrs was significant between two groups (p<0.0099). The time taken to administer the first dose of rescue analgesic was significantly delayed in Lornoxicam group 194.96 ±103.94 minutes, when compared to Tramadol group 159.44 ±70.4minutes. The degree of satisfaction with post operative pain management in Tramadol group was good in 64% of women and 34% had fair scores, however none of them had excellent scores. Whereas in Lornoxicam group 16% of women had excellent scores, 66% had good scores and 18% had fair scores. The side effects like nausea and vomiting was seen in 15 women in Tramadol group and 3 women in Lornoxicam group. Conclusion: In our study Lornoxicam was found to be better pre-emptive analgesic when compared to Tramadol because the time taken for first rescue analgesic was significantly delayed, as well as the total rescue analgesic consumed was less compared to Tramadol. Hence Lornoxicam can be used in place of Tramadol as pre-emptive analgesic due to its above mentioned advantages as well as lesser side effects.