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In day care ear, nose, and throat (ENT) surgeries, patients are admitted and discharged on the same day, provided they are free of anesthetic and surgical side effects. In this prospective randomized study, we compared the perioperative analgesic efficacy and side effects like nausea, sedation, and respiratory depression 24 hours postsurgery with use of lornoxicam and fentanyl. Background: Although opioids are traditionally used in managing postoperative pain, their side effects like nausea, respiratory depression, sedation, constipation, urinary retention, and itching limit their use. This may result in delayed discharge and prolonged hospital stay in day care surgery. Nonsteroidal anti-inflammatory drugs have central and peripheral analgesic effects, anti-inflammatory properties, and relatively better tolerability with few side effects.1,2. Materials and methods: After institutional Ethics Committee approval, 100 patients were randomly allocated into two groups (50 each). Various parameters like intraoperative heart rate, blood pressure, postoperative pain, analgesic requirement, respiratory depression, sedation, and nausea scores were studied. Statistical analysis: Analysis of quantitative data with unpaired t-test and qualitative data with chi-square test. Results: The heart rate was higher in the fentanyl group (B) than in the lornoxicam group (A) during reversal and extubation, with p-value <0.05. The visual analog scale scores were higher in group (B) than in group (A), with p value <0.05 for 2 hours. Need for rescue analgesia was more in group (B) with 51 patients within hour of surgery and 11 patient in group (A) up to 8 hours postsurgery. The p values for nausea scores were 0.0001, 0.0011, and 0.0001 at 30 min, 1 hour, and 2 hours, respectively, and were higher in group (B).The p value for sedation score was 0.002. The respiratory rate was lower in group (B) up to 8 hours postsurgery. Conclusion: Lornoxicam has good intraoperative and better postoperative analgesia as compared with fentanyl in minor to moderate ENT surgeries. The need for rescue analgesia is less in lornoxicam group. Lornoxicam was also found to have a lower incidence of side effects like nausea, sedation, and respiratory depression.

research and innovation in anesthesia

Randomized Prospective Study of Comparison of Intravenous Lornoxicam and Intravenous Fentanyl for Intraoperative and Postoperative Analgesia in Minor to Moderate Ear, Nose, and Throat Surgeries