Analgesic effect of lornoxicam or combined with bupivacaine,morphine or buprenorphine injected intra-articularly after knee arthroscopy

Objective: To evaluate the analgesic effect of intra-articular administration of lornoxicam or combined with bupivacaine,morphine or buprenorphine after knee arthroscopy.Methods: One hundred twenty patients from the Hospitals in Tata and the Kindom of Settat in Morocco were assigned to six groups(n=20).Group A received lornoxicam 8 mg in 0.9% NaCl to 20 ml i.a,group B received morphine 2 mg in 0.9% NaCl to 20 ml i.a,group C lornoxicam 8 mg and bupivacaine 0.5% 20 ml i.a,group D morphine 2 mg and bupivacaine 0.5% 20 ml i.a,group E buprenorphine 100 μg and lornoxicam 8 mg in 0.9% NaCl to 20 ml i.a and group F morphine 2 mg and lornoxicam 8 mg in 0.9% NaCl to 20 ml i.a.The intensity of postoperative pain was evaluated by pain intensity(PI),pain intensity difference(PID) and pain relief(PAR) at 0.25,0.5,1,4,8,16,20,24 hour after operation when the passive knee flexion was 90°.The total impression of analgesic effect and side effects related to the drugs were recorded.Results: The PID values were significantly higher in group C,D and F than those in group A and B at 0.25,0.5,16,20,24 h after operation(P<0.01).The PAR values were significantly lower in group C,D,E and F than those in group A and B at 0.25,0.5,16,20,24 h after operation(P<0.01).Group A showed a higher PID value and a lower PAR value compared to group B at 8 and 16 h after operation(P<0.01).The total impression scores of analgesia among group C,D,E and F did not have statistical difference,but their scores were superior to those of the other two groups during the postoperative period(P<0.01).Abdominal distension and nausea were observed in 7 cases in group E and 9 cases in group F.Conclusions: Intra-articular use of lornoxicam combined with bupivacaine,buprenorphine or morphine provides better analgesic effect than the administration of lornoxicam alone after knee arthroscopic surgery.