Comparison of Analgesic Effects of Intraperitoneal Lornoxicam and Ropivacaine Administration in Laparoscopic Cholecystectomy

Objectives: In this randomized prospective study, we investigated the effects of lornoxicam vs. ropivacaine for the management of postoperative pain in patients under-going elective laparoscopic cholecystectomy. Patients and Methods: Patients were randomized into three groups and received 150 mg (80 mL) ropivacaine or 16 mg lornoxicam (80 mL) or placebo (80 mL saline) via multi-regional intraperitoneal instillation and port sites infiltration. Patient-controlled analgesia (PCA) device was used. Tramadol 50 mg tolerable dose, 5 mg/hour basal infusion, bolus dose 20 mg, locked 30 min, 4 hour limit were applied as 200 mg. Postoperative pain was assessed with 100-mm visual analog scale (VAS) at rest, while coughing, and during mobilization. Pain scores were recorded in the post-anesthesia care unit, and at 2, 4, 8, 12,18 and 24 h after the surgery. Results: At 24 h, VAS scores at rest and while cough-ing were found significantly lower in ropivacaine and lornoxicam group when compared with control group (p=0.047). The percentage of patients needing tramadol was significantly lower with ropivacaine and lornoxicam compared with control (p 0.001, p=0.018). There was no statistically significant difference between ropivacaine and lornoxicam group. Conclusion: Multi-regional, intraperitoneal instillation and port site infiltration of ropivacaine and lornoxicam during laparoscopic cholecystectomy reduces the post-operative pain.