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Materials and Methods: We studied 50 patients ASA I, II who were programmed for major operations under general anesthesia used remifentanil as the perioperative opioid (1 μg·kg−1 as a bolus then 0.5 μg·kg−1/min as a continuous infusion). The patients were divided randomly into two groups, A (n = 25 pts) and B (n = 25 pts) with comparative demographic characteristics. A morphine bolus of 0.25mg·kg−1 with lornoxicam (A Group) or 0.25 mg·kg−1 (B Group) was administered 30 min before the end of surgery. In the postanesthesia care unit, pain scores for patients were evaluated by using visual analog scale scores of 0-10. Postoperative analgesia was obtained by a morphine titration (2 mg every 5 min). We recorded: a) the postoperative pain level, b) the need for complementary morphine, c) the modified Aldrete scale, d) the opioid spare effect, e) the adverse reactions. Adequate analgesia was accepted with a pain score of 0-3. The statistical evaluation was done using the student t-test. Values of p < 0.05 were accepted as statistically significant.
Results and Discussions: There was no demographic difference between the two groups. Post operative analgesia was not effective in both groups which were studied. By comparing the mean pain value we determined a statistically significant difference between two groups with the higher levels of pain being noted in patients of group B (p < 0.05).
Statistical significance in the mean pain value between the two groups were observed at 30 min (p < 0.04), 45 min (p < 0.02) and 60 min (p < 0.02). The complementary use of morphine was 8.2 ± 2.9 in group A and 9.3 ± 1.9 in group B, a difference which was not statistically significant. Comparing the modified Aldrete scale, found no statistical significant difference between the two groups. No statistical differences were found in the side effects.
Conclusions: a) The postoperative analgesia of the two groups was unsatisfactory, although there was statistically significant difference in the level of pain, b) the complementary administration of morphine did not yield significant statistical difference, c) no statistical difference was noted in the modified Aldrete scale, d) the opioid spare effect in group A was 12% and e) no differences noted in the adverse reactions between the two studied groups.
