Continuous Lornoxicam Infusion for Orthopaedic Surgery
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Purpose
Perioperative continuous infusion of lornoxicam would be an effective and safe regimen to reduce the patient controlled morphine consumption after orthopaedic surgery.
After ethical approval, 96 patients scheduled for elective orthopaedic fracture surgery under general anaesthesia were randomly allocated to receive placebo, 12-hourly iv lornoxicam 16 mg or lornoxicam 16 mg followed with continuous infusion of 1.3 mg/hr., for 48 hours after surgery (n=32 per group). Anaesthesia was induced with propofol, sufentanil and rocuronium, and was maintained with 0.5-1 minimum alveolar concentration sevoflurane, sufentanil and rocuronium. Postoperative patient controlled morphine analgesia was used. Changes in heart rate, mean blood pressure and sevoflurane minimum alveolar concentration, visual analogue pain scores, and cumulative patient controlled morphine consumptions and blood loss for 48 hours, platelet functions, bone non-union and the presence of adverse effects were recorded.
| Condition | Intervention | Phase |
|---|---|---|
|
Closed Non Comminuted Long Bone Fractures |
Drug: Placebo Drug: Continuous infusion Drug: Scheduled |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Efficacy of Continuous Intravenous Infusion vs. Scheduled Dosing of Lornoxicam on Patient Controlled Morphine Consumption After Orthopaedic Surgery: A Comparative Placebo Study |
- postoperative patient controlled morphine consumption [ Time Frame: 24 hours and 48 hours after surgery ] [ Designated as safety issue: No ]The cumulative morphine consumption during the first 24 and 48 postoperative hours were recorded.
- Quality of analgesia [ Time Frame: every two hours for 24 hours after surgery ] [ Designated as safety issue: No ]the use of visual analogue scale to assess the severity of postoperative pain (0 mm for no pain and100 mm for worst imaginable pain)
- platelet functions [ Time Frame: daily after surgery for three days ] [ Designated as safety issue: Yes ]
- Bone non-union [ Time Frame: for 3 months after surgery ] [ Designated as safety issue: Yes ]
- postoperative sedation [ Time Frame: every two hours for 24 hours after surgery ] [ Designated as safety issue: Yes ]four-point verbal rating scores (VRS): awake, drowsy, rousable or deep sleep),
- Nausea and vomiting [ Time Frame: every two hours for 24 hours after surgery ] [ Designated as safety issue: Yes ]nausea and vomiting (0: no nausea; 1: nausea no vomiting; 2: nausea and vomiting),
- Perioperative blood loss [ Time Frame: Cumulative intraoperative and 24 hours after surgery ] [ Designated as safety issue: Yes ]
- Lornoxicam adverse effects [ Time Frame: 48 hours after surgery ] [ Designated as safety issue: Yes ]the presence of nausea, vomiting, gastritis, reflux esophagitis, headache, bleeding, bronchospasm, sweating, allergy, thrombocytopenia, bleeding, ecchymosis, or increases in liver transaminases.
| Estimated Enrollment: | 96 |
| Study Start Date: | June 2012 |
| Estimated Study Completion Date: | February 2013 |
| Estimated Primary Completion Date: | December 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Placebo Comparator: Placebo
The placebo group received 12 hourly boluses of 0.9% saline, followed by a constant infusion for 48 hrs after surgery.
|
Drug: Placebo
The placebo group received 12 hourly 20-mL i.v. boluses of 0.9% saline starting 20 min before induction of anaesthesia, followed by a constant infusion at 10 mL/h, for 48 hrs after surgery.
|
|
Active Comparator: Scheduled
They received a 12 hourly boluses of lornoxicam followed by a constant infusion of 0.9% saline, for 48 hrs after surgery
|
Drug: Scheduled
The "scheduled" group received an 12 hourly 20-mL i.v. boluses of lornoxicam 0.8 mg/mL starting 20 min before induction of anaesthesia followed by a constant infusion at 10 mL/h of 0.9% saline, for 48 hrs after surgery (supplied by Xefo, JPI, Saudi Arabia), starting 20 min before induction of anaesthesia.
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Active Comparator: Continuous infusion
They received boluses of lornoxicam 0.8 mg/mL before induction of anaesthesia followed by a 12 hourly boluses of 0.9% saline and a constant infusion at 10 mL/h of lornoxicam 0.13 mg/mL, for 48 hrs. after surgery.
|
Drug: Continuous infusion
The "continuous infusion" group received 20-mL i.v. boluses of lornoxicam 0.8 mg/mL starting 20 min before induction of anaesthesia followed by a 12 hourly 20-mL i.v. boluses of 0.9% saline and a constant infusion at 10 mL/h of lornoxicam 0.13 mg/mL, for 48 hrs. after surgery
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years to 55 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- American Society of Anesthesiologists physical class I to III
- Age from 18 to 55 years
- Closed non comminuted long bone fractures
- Elective orthopaedic fracture surgery
- General anaesthesia
Exclusion Criteria:
- Hypersensitivity to lornoxicam
- Gastrointestinal ulceration or bleeding
- Cardiac diseases
- Pulmonary diseases
- Hepatic diseases
- Renal diseases
- Clotting diseases
- Bleeding diseases
- Bronchial asthma
- Diabetes mellitus
- Peripheral arterial occlusive disease
- Morbid obesity
- Pregnancy
- Alcohol or drug abuse
- Receiving other NSAIDs a day before surgery
Contacts and Locations| Contact: Mohamed R El Tahan, MD | +966569371849 | mohamedrefaateltahan@yahoo.com |
| Egypt | |
| Anesthesiology Dept., College of Medicine, Mansoura University | Recruiting |
| Mansoura, DK, Egypt, 050 | |
| Sub-Investigator: Salwa Hawas, MD | |
| Principal Investigator: Eiad A Ramzy, MD | |
| Sub-Investigator: Douaa G Diab, MD | |
| Sub-Investigator: Nahla S El Bahnsawy, MD | |
| Sub-Investigator: Hany A Mowafi, MD | |
| Sub-Investigator: Talal A Albrahimi, MD | |
| Principal Investigator: | Mohamed R El Tahan, MD | College of Medicine, Mansoura University |
More Information
No publications provided
| Responsible Party: | Mohamed R El Tahan, Associate Professor of Anesthesiology & SICU, Mansoura University |
| ClinicalTrials.gov Identifier: | NCT01718756 History of Changes |
| Other Study ID Numbers: | R/55 |
| Study First Received: | October 28, 2012 |
| Last Updated: | October 30, 2012 |
| Health Authority: | Egypt: Ministry of Higher Education |
Keywords provided by Mansoura University:
|
Orthopaedic General anaesthesia lornoxicam patient controlled analgesia morphine consumption |
Additional relevant MeSH terms:
|
Fractures, Bone Wounds and Injuries Anesthetics Lornoxicam Central Nervous System Depressants Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents |
Therapeutic Uses Anti-Inflammatory Agents, Non-Steroidal Analgesics, Non-Narcotic Analgesics Sensory System Agents Peripheral Nervous System Agents Anti-Inflammatory Agents Antirheumatic Agents |
ClinicalTrials.gov processed this record on May 16, 2013