Analgesic Effectiveness And Safety Of Lornoxicam For Postoperative Pain Relief And Effects Of Postoperative Pain Treatment With Lornoxicam On T-lymphocyte Subsets

Background: The treatment of postoperative pain in children has improved in recent years, but some adverse effects of analgesics, respiratory depression in particular, have caused a great concern about safety in their application. Lornoxicam is a new non-steroidal anti-inflammatory analgesic with an excellent analgesic effect and a little adverse effect in adults,but there was no data about its use in children. So, this study was designed to compare the effectiveness and safety of tramadol and lornoxicam for postoperative pain relief and to evaluate the effects of postoperative pain treatment with lornoxicam on T-lymphocyte subsets in children.Methods: Ninety ASA I -II children aged 7-14 yr scheduled for elective surgery under general anesthesia were selected and randomly divided intothree groups, group L (the lomoxicam group)(n = 30); group T (the tramadol group)(n = 30); group C (the control group) (n = 30) . In group L, the postoperative analgesia was induced by an intramuscular injection of lornoxicam 0.25 mg/kg at the end of the operation; in group M, tramadol 2 mg/kg at the end of the operation; and in group C, no analgesic was given. The faces pain score and the sedation score determined by the 3-point test, and adverse effects were assessed to determine the analgesic effectiveness and adverse effects of lornoxicam. To evaluate the effect of postoperative pain treatment with lornoxicam on T-lymphocyte subsets, blood samples in groups L and C were taken from the peripheral vein before anesthesia, 6 h and 24 h after surgery for determination of the levels of CD3"1", CD4 , CDg T cells by the flow cytometry.Results: The demographics did not differ among the three groups. The analgesic effectiveness in group L was better than that in group T, with a lower pain score at 2h and 4h after surgery (P < 0.05); the sedation score and the incidence of postoperative nausea and vomiting in group L (13%) was significantly lower than that in group T (36%, P < 0.05), but did not differ between groups L and C (P > 0.05). T-lymphocyte subsets and the CD/ /CD8+ ratio in the two groups did not have significant differences. Comparedwith the values before anesthesia, T-lymphocyte subsets decreased slightly during the postoperative period in both groups (P > 0.05), but in group L the level of T-lymphocyte subsets increased (P > 0.05) 24 h after operation. There were no infectious complications or abnormal hemorrhage. Conclusions: Lomoxicam has a better analgesic effect for postoperative pain in children than tramadol, and the adverse effect is milder than that of tramadol. There is no significant suppression of cellular immune function in children after operation. Analgesia with a lomoxicam injection has no significant effect on cellular immune function.