Comparison of Lornoxicam and Paracetamol for Pre-emptive Intravenous Analgesia for Elective Inguinal Hernia Repair

Study Overview
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Brief Summary
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The purpose of this study is to determine whether lornoxicam or paracetamol is more effective in providing pre-emptive analgesia for adult patients undergoing elective unilateral inguinal hernia repair under general anesthesia.

Detailed Description
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Early postoperative pain is the major cause that may restric physical activity of the patients and delay in returning work. Newer non-steroid analgesic drugs (NSAD) can be helpful in overcoming this problem, especially in pre-emptive use. In this prospective randomized placebo controlled double blinded study we aimed to determine whether lornoxicam, as a NSAD, or paracetamol is more effective in providing pre-emptive analgesia for patients undergo elective unilateral inguinal hernai repair under general anesthesia. 60 patients above the age of 18, ASA score of I to III will be assigned into 3 groups. All the patients will be operated under general anesthesia. Recurrent hernia cases, pregnant or lactated women, patients allergic to the two drugs, patients with documented gastric disorders or bleeding disorder or under anticoagulent therapy will be excluded. Group designs: Group I: 100 ml intravenous saline infusion as placebo 30 minitues before the surgery. Group II: 8 mg intravenous lornoxicam infusion in 100 ml saline 30 minitues before the surgery. Group III: 1 g intravenous paracetamol infusion in 100 ml saline 30 minitues before the surgery. All patients will receive patient controlled intravenous analgesia with morphine for 24 hours postoperatively. Postoperative pain levels will be determined by VAS (visual analog scale) and morphine consumption will be recorded. Patients will be prescribed with oral paracetamol (300 mg) plus codein (15 mg)at discharge at the end first 24 hours. Patients will be asked to record daily consumption of given analgesic, pain response to physical activity by using Likert scale, and VAS scores daily. The first follow-up examination will take place on day-7. The patients will be asked to keep recording the same parameters until the second hospital visit at 4th week. On the follow-up examination at 4th week quality of life will be determined by SF-36 form. The results will be analyzed using SPSS for Windows software.

Official Title
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Pre-emptive Intravenous Analgesia for Elective Inguinal Hernia Repair: Prospective Randomized Double-blinded Placebo Controlled Comparison of Lornoxicam and Paracetamol

Conditions
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Inguinal Hernia, Postoperative Pain

Intervention / Treatment
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* Other: Sterile Saline
* Drug: Intravenous lornoxicam
* Drug: Intravenous paracetamol


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: inguinal hernia unilateral hernia general anesthesia elective repair Exclusion Criteria: drug allergy bilateral hernia local anesthesia local blockade regional anesthesia emergency surgery complicated hernia recurrent hernia

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Placebo Control<br>Group I (Placebo Control) 100 ml intravenous saline infusion as placebo 30 minitues before the surgery. | Other: Sterile Saline<br>* Group I: 100 ml intravenous saline infusion as placebo 30 minitues before the surgery.<br>* Other names: Saline;|
| Active Comparator: Lornoxicam<br>Group II: 8 mg intravenous lornoxicam infusion in 100 ml saline 30 minitues before the surgery. | Drug: Intravenous lornoxicam<br>* Group II: 8 mg intravenous lornoxicam infusion in 100 ml saline 30 minitues before the surgery.<br>* Other names: Lornoxicam: Xefo;|
| Active Comparator: Paracetamol<br>Group III: 1 g intravenous paracetamol infusion in 100 ml saline 30 minitues before the surgery. | Drug: Intravenous paracetamol<br>* Group III: 1 g intravenous paracetamol infusion in 100 ml saline 30 minitues before the surgery.<br>* Other names: Paracetamol: Perfalgan;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative pain and comfort |  | 24 and 48 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative late pain complaint and quality of life |  | 4. week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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inguinal hernia, surgery, general anesthesia, analgesia, pre-emptive, SF36