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BJA Advance Access published online on July 15, 2006
British Journal of Anaesthesia, doi:10.1093/bja/ael170
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Accepted May 23, 2006

Clinical Investigation

The analgesic effect of lornoxicam when added to lidocaine for intravenous regional anaesthesia

S. Sen 1 *, B. Ugur 1, O. N. Aydin 2, M. Ogurlu 1, E. Gezer 1, and O. Savk 3

1 Department of Anaesthesiology and Reanimation, Adnan Menderes University, Medical Faculty, Aydin, Turkey
2 Department of Anaesthesiology and Reanimation/Algology, Adnan Menderes University, Medical Faculty, Aydin, Turkey
3 Department of Orthopaedics, and Traumatology, Adnan Menderes University, Medical Faculty, Aydin, Turkey

* To whom correspondence should be addressed.
S. Sen, E-mail: drseldasen{at}yahoo.com


  Abstract

Background. The aim of the study was to evaluate the effect of lornoxicam (L) on sensory and motor block onset time, tourniquet pain, and postoperative analgesia, when added to lidocaine in intravenous regional anaesthesia (IVRA).

Methods. Forty-five patients undergoing hand surgery were randomly and blindly divided into three groups as to receive either i.v. saline and IVRA with lidocaine 0.5% (Control group, n=15), i.v. saline and IVRA lidocaine 0.5% with lornoxicam (L-IVRA group, n=15), or intravenous lornoxicam and IVRA lidocaine 0.5% (L-IV group, n=15). Sensory and motor blocks onset time, and tourniquet pain was measured after tourniquet application at 5, 10, 20, and 30 min, and analgesic use were recorded during operation. After the tourniquet deflation, at 1, 30 min, and 2, 4 h, visual analogue scales score, the time to first analgesic requirement, total analgesic consumption in first 24 h, and side effects were noted.

Results. Sensory and motor block onset times were shorter and the recovery time prolonged in the Group L-IVRA compared with the other group (P=0.001). A decreased tourniquet pain, a prolonged time first analgesic requirement [229 (85) min vs 28 (20) and 95 (24) min, P=0.0038) and less postoperative analgesic requirements during 24 h were found in Group L-IVRA compared with the other groups (P<0.05).

Conclusions. The addition of lornoxicam to lidocaine for intravenous regional anaesthesia shortens the onset of sensory and motor block, decreases tourniquet pain and improves postoperative analgesia without causing any side effect.

Keywords: anaesthetic techniques, regional, i.v.; anaesthetics local, lidocaine; analgesia, postoperative; analgesics, NSAIDs, lornoxicam; pain, postoperative; pain, tourniquet pain.
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