Preoperative peritonsillar lornoxicam infiltration is not superior to intravenous lornoxicam for pain relief following tonsillectomy in adults

Ismail, Salah A.; Mowafi, Hany A.

doi:10.1097/eja.0b013e32833c3101

Cited by 15 publications

(17 citation statements)

References 28 publications

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“…This preliminary study shows promising results in reducing the operative time, efficacy on OSA and a very simple learning curve. Post-operative pain is a common problem in palatal surgery and some patients experience an unacceptable level of intense post-operative pain 6 - 8 . In BRP, the healing time and post-operative pain is related mostly to tonsillectomy; in fact, in patients who underwent previously tonsillectomy, usually very minimal post-operative pain and rapid oral feeding is reported in our sleep surgery experience.…”

Section: Discussionmentioning

confidence: 74%

Barbed reposition pharyngoplasty in multilevel robotic surgery for obstructive sleep apnoea

Vicini

Meccariello

Cammaroto

et al. 2017

Acta Otorhinolaryngol Ital

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Il trattamento chirurgico delle apnee ostruttive in sonno rappresenta una valida alternativa per i pazienti non complianti al ventilatore CPAP. Negli ultimi anni, lapproccio chirurgico multilivello sta divenendo pratica comune, soprattutto dallintroduzione della chirurgia robotica. La Barbed Reposition Pharyngoplasty nella chirurgia robotica multilivello per OSA potrebbe rappresentare una valida opzione per il trattamento del palato molle. In questo lavoro descriviamo la tecnica e risultati preliminari della nostra esperienza.

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Section: Discussionmentioning

confidence: 74%

Barbed reposition pharyngoplasty in multilevel robotic surgery for obstructive sleep apnoea

Vicini

Meccariello

Cammaroto

et al. 2017

Acta Otorhinolaryngol Ital

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“…A total of 36 studies met our inclusion criteria, which included 4878 subjects. This included 1446 adults and 1747 children.…”

Section: Resultsmentioning

confidence: 99%

“…A summary of the characteristics of these trials is presented in Table . The NSAIDs that were used in the trials are as follows: ASA, diclofenac, flurbiprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, lornoxicam and tenoxicam . The NSAIDs were compared to various controls including the following: paracetamol, papaveretum, paracetamol with codeine, tramadol, metamizole sodium, morphine, codeine, meperidine, fentanyl, propacetamol, lidocaine infusion or placebo .…”

Section: Resultsmentioning

confidence: 99%

“…Tonsillectomy was performed by electrocautery dissection in 10 studies and cold steel technique in three studies . The outcomes that were measured included the following: postoperative haemorrhage, bleeding requiring reoperation, secondary haemorrhage, bleeding requiring readmission, bleeding requiring electrocautery, profuse/more than average bleeding and blood loss …”

Section: Resultsmentioning

confidence: 99%

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A 2013 updated systematic review & meta‐analysis of 36 randomized controlled trials; no apparent effects of non steroidal anti‐inflammatory agents on the risk of bleeding after tonsillectomy

Riggin

Ramakrishna

Sommer

et al. 2013

Clinical Otolaryngology

163

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Background Although the literature suggests that non‐steroidal anti‐inflammatory drugs (NSAIDs) are effective in controlling post‐operative pain in the paediatric population, physicians have been reluctant to utilise these medications after tonsillectomy due to concerns of increased bleeding rates. While many surgeons prescribe opioid analgesics postoperatively, these are associated with a number of potential adverse side‐effects including nausea, vomiting, constipation, excessive sedation and respiratory compromise. Objective of review To compare bleeding rates and severity between recipients of NSAIDs versus placebo or opioid analgesics for tonsillectomy. Search strategy Two authors independently searched electronic databases including PubMed, OVID, EMBASE and Cochrane Review from inception to July 2012. The keywords used included: Adenotonsillectomy, Tonsillectomy, Analgesia, Bleeding, Perioperative and Postoperative. These were then combined in various combinations with specific NSAIDs. Evaluation method A systematic review and meta‐analysis of all randomised control trials comparing bleeding rates and severity between NSAIDs versus placebo or opioids post‐tonsillectomy. Results A total of 36 studies met our inclusion criteria including 1747 children and 1446 adults. When all of the studies were combined in a meta‐analysis using the most severe outcome, there was no increased risk of bleeding in those using NSAIDs after tonsillectomy. Use of NSAIDs in general [1.30 (0.90–1.88)] or in children [1.06 (0.65–1.74)] was not associated with increased risk of bleeding in general, most severe bleeding, secondary haemorrhage, readmission or need of reoperation due to bleeding. Similarly, there was no increased bleeding risk for specific NSAIDs in adults. In the studies looking at paediatric subjects, the overall odds ratio of bleeding was even lower than in the general population and not significant. This result is based on 18 studies, six of which had zero outcomes in either treatment arm. Similar to the general population analysis, there was no significant difference in any of the subanalyses: bleeds treated with reoperation, readmission or bleeds in children that could be managed conservatively. There were also no significant differences in the subanalyses of individual NSAIDs. Similarly, there was no significant difference in rates of bleeding in the subanalysis of studies that gave NSAIDs multiple times, for instance, both before and after surgery. Conclusions These results suggest that NSAIDs can be considered as a safe method of analgesia among children undergoing tonsillectomy.

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“…The peroral and parenteral forms of lornoxicam have been used to treat moderately acute postoperative pain (5,7). In addition, local administration of lornoxicam combined with a local anesthetic has been found safe and effective in clinical trials (8,9). However, the efficacy of wound infiltration analgesia with lornoxicam alone for postoperative pain management after thyroid surgery has not been studied yet.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of wound infiltration with lornoxicam for postoperative analgesiafollowing thyroidectomy: a prospective, randomized, double-blind study

Kılbaş¹,

Mentes²,

Harlak³

et al. 2015

Turk J Med Sci

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Background/aim: Postoperative pain control constitutes a major problem and studies have focused on reducing opioid requirements using regional techniques. We aimed to investigate the efficacy of wound infiltration with lornoxicam on postoperative pain control following thyroidectomy. Materials and methods:In this prospective, randomized-controlled study, 80 patients scheduled for thyroidectomy were randomly assigned to 2 groups. After the thyroidectomy was performed, patients in group I underwent wound infiltration with 4 mg of lornoxicam and patients in group II received the same amount of saline. Rescue analgesia was provided with additional doses of lornoxicam delivered by an on-demand patient-controlled analgesia device. Total analgesic consumption during the postoperative 24 h, and pain intensities assessed using a visual analog scale score at 0, 2, 4, 8, 12 and 24 h postoperatively were recorded.Results: Pain scores during the postoperative 24 h were slightly lower in group I than in group II, but the difference was not significant (P > 0.05). The mean analgesic consumption was 8.87 ± 1.87 mg and 10.33 ± 1.25 mg in groups I and II, respectively (P > 0.05). Conclusion:Wound infiltration with lornoxicam neither improved postoperative pain control nor decreased total analgesic consumption.

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Preoperative peritonsillar lornoxicam infiltration is not superior to intravenous lornoxicam for pain relief following tonsillectomy in adults

Abstract: Peritonsillar infiltration or i.v. lornoxicam enhanced postoperative analgesia after tonsillectomy in adults. However, the analgesic efficacy of locally applied lornoxicam is not superior to the i.v. administration.

Cited by 15 publications

References 28 publications

Barbed reposition pharyngoplasty in multilevel robotic surgery for obstructive sleep apnoea

Barbed reposition pharyngoplasty in multilevel robotic surgery for obstructive sleep apnoea

A 2013 updated systematic review & meta‐analysis of 36 randomized controlled trials; no apparent effects of non steroidal anti‐inflammatory agents on the risk of bleeding after tonsillectomy

Efficacy of wound infiltration with lornoxicam for postoperative analgesiafollowing thyroidectomy: a prospective, randomized, double-blind study

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