A Comparison of the Efficacy and Tolerability of Lornoxicam and Diclofenac Sodium in Patients with Acute Postoperative Pain after Spinal Surgery

Spinal fusion surgery causes severe postoperative pain, hampering reconvalescense. Nonsteroidal anti-inflammatory drugs are used in the management of postoperative pain to avoid the adverse effects associated with opioids. Lornoxicam use is increasing for postoperative pain management. However, lornoxicam has not been studied for use in pain management after spinal surgery. In the present study, analgesic efficacy and tolerability of lornoxicam and diclofenac sodium were compared in post operative spinal surgery patients. This single blinded, randomized, prospective comparative study of lornoxicam (8 mg) versus diclofenac (75 mg) was conducted at Stavya Spine Hospital, Ahmedabad, Gujarat. 47 patients were enrolled in the study. After spinal surgery, 23 patients received diclofenac sodium and 24 patients received lornoxicam. Pain were assessed at baseline (0 min), 15 mins, 30 mins, 45 mins, 60 mins, 90 mins, 120 mins, 180 mins, 240 mins, 300 mins, and 360 mins by visual analog scale of 10 points. Adverse events were recorded for both groups. Laboratory safety parameters were measured before and after 24 hrs of surgery. The pain relief score were significantly (<0.001) reduced at measured time points as compared to baseline for both groups. However, difference (p< 0.05) between lornoxicam and diclofenac treated groups for pain relief score were found only at 30 mins and 300 mins after drug administration. Lornoxicam has slightly greater efficacy than diclofenac in acute post operative pain with similar tolerability and safety. Thus, lornoxicam is a better alternative for diclofenac in acute post operative after spinal surgery.

Author(s): Galani Varsha J, Patel Nimesh A, Bhart R Dave, Ajay Krishnan

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