Cionac Florescu S, Anastase DM, Munteanu AM, Porumbac G, Mihailide N (2016) A Randomized Parallel Controlled Study of the Eficacy and Safety of Lornoxicam Versus Etoricoxib after Total Knee Arthroplasty. Int J Anesth Res. 4(12), 373-376. 373 OPEN ACCESS http://scidoc.org/IJAR.php International Journal of Anesthesiology & Research (IJAR) ISSN 2332-2780 *Corresponding Author: Simona Florescu Cionac, Department of Anaesthesiology, Clinical Hospital of Orthopaedics Foisor, Bd. Ferdinand nr. 35-37, 021382, Bucharest, Romania. Tel: 0040722381861 E-mail: lorescut@yahoo.com Received: November 21, 2016 Accepted: December 15, 2016 Published: December 17, 2016 Citation: Cionac Florescu S, Anastase DM, Munteanu AM, Porumbac G, Mihailide N (2016) A Randomized Parallel Controlled Study of the Eficacy and Safety of Lornoxicam Versus Etoricoxib after Total Knee Arthroplasty. Int J Anesth Res. 4(12), 373-376. doi: http://dx.doi.org/10.19070/2332-2780-1600077 Copyright: Cionac Florescu S © 2016. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distri bution and reproduction in any medium, provided the original author and source are credited. Introduction Pain relief after total knee arthroplasty continues to be a subject of debate. Although there are a variety of pharmacological thera- pies, no ideal drug has been found to date [1, 2]. Non-steroidal anti-inlammatory drugs (NSAIDs) are commonly used for the treatment of post-operative pain in order to reduce opioids administration and their adverse effects [3, 4]. Cyclooxygenase-2 (COX-2) speciic inhibitors are advantageous over the previous generations of NSAIDs in terms of safety, since they have signiicantly less gastrotoxicity and no effects on platelet aggregation, important in the postoperative setting [5, 6]. Etoricoxib [7] belonging to the second class of selective inhibitors of COX-2, has a good absorption rate and a half-life of 22 hours that allows administration of a single 120 mg tablet daily. Litera- ture data show that its absorbtion is complete in about 24 minutes after administration [8] and its postoperative use as an analgetic was demonstrated to be eficient and safe. Rawal et al., used post- operative etoricoxib 90 and 120 mg in patients undergoing TKA and found it superior to placebo and non-inferior to ibuprofen in reducing pain at rest and morphine consumption [9]. Rasmussen et al., used etoricoxib 120 mg daily on 228 patients with knee and hip arthroplasty and showed it provided analgesia similar to naproxen sodium 1100 mg at the irst 24 hours after surgery and superior to placebo, with reduced opioid medication [10]. Lornoxicam [7] is a potent new NSAIDs oxicam derivative, which Abstract Objectives: The aim of the study was to compare the postoperative analgesic eficacy and safety of lornoxicam versus etoricoxib for the irst 48 hours after surgery. Methods: We conducted a prospective randomized controlled study on 110 patients ASAI-II scheduled for TKA under spinal anesthesia, who received either lornoxicam 8 mg PO at the end of surgery and a further 8 mg after 12 hours (Lor- noxicam Group) or etoricoxib 120 mg at the end of surgery and one placebo pill after 12 hours (Etoricoxib Group). The primary outcome measure was the cumulative dose of morphine administered during the irst postoperative 24 and 48 hours. Secondary outcomes were duration of analgesia and the side effects of the treatment. Results: The groups were similar in terms of demographic data. There are no signiicant differences between groups re- garding the morphine consumption at 24 hours (36.2 ± 12 in Lornoxicam group and 34.5 ± 14.1 in Etoricoxib group) and 48 hours postoperatively (15.6 ± 12.8 in Lornoxicam group and 18 ± 12.3 in Etoricoxib group) or between the duration of analgesia (314.5 ± 70.4 in Lornoxicam group and 320.4 ± 89.2 in Etoricoxib group). Conclusion: Postoperative use of lornoxicam for 48 hours in the dose of 8 mg PO twice a day in patients undergoing TKA has an analgetic effect comparable to etoricoxib 120 mg, fewer patients experienced adverse symptoms in the etoricoxib group, but the difference was not statistically signiicant. Keywords: TKA; Postoperative Pain; Lornoxicam; Etoricoxib. A Randomized Parallel Controlled Study of the Eficacy and Safety of Lornoxicam Versus Etoricoxib after Total Knee Arthroplasty Research Article Cionac Florescu S 1* , Anastase DM 1 , Munteanu AM 1 , Porumbac G 1 , Mihailide N 2 1 Department of Anaesthesiology, Clinical Hospital of Orthopaedics Foisor, Bd. Ferdinand nr. Bucharest, Romania. 2 Department of Orthopaedics, Clinical Hospital of Orthopaedics Foisor, Bd. Ferdinand nr. Bucharest, Romania.