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Lornoxicam attenuates the haemodynamic responses to laryngoscopy and tracheal intubation in the elderly*

Published online by Cambridge University Press:  01 September 2008

W. Riad  and
A. Moussa
W. Riad*
Affiliation:
King Khaled Eye Specialist Hospital, Department of Anesthesia, Riyadh, Saudi Arabia
A. Moussa
Affiliation:
King Faisal Specialist Hospital and Research Center, Department of Anesthesia, Riyadh, Saudi Arabia
*
Correspondence to: Waleed Riad, Department of Anaesthesia, King Khaled Eye Specialist Hospital, PO Box 7191, Riyadh 11462, Saudi Arabia. E-mail: [email protected]; Tel: +966 1 482 1234 3215; Fax: +966 1 482 1908
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Summary

Background and objectives

Lornoxicam is a novel non-steroidal anti-inflammatory drug with marked analgesic property. It has been shown to have analgesic potency similar to morphine and meperidine. Laryngoscopy and tracheal intubation provoke major haemodynamic responses. Minimizing perioperative adverse events in elderly patients is of utmost importance. The aim of this study was to demonstrate the effect of preoperative administration of Lornoxicam on haemodynamic changes during laryngoscopy and tracheal intubation in the elderly.

Methods

Fifty patients aged between 65 and 75 yr were randomly recruited to this randomized, double-blind, placebo-controlled study. They were divided into two groups to receive either Lornoxicam 8 mg or placebo half an hour before surgery. Systolic and diastolic blood pressure, mean arterial pressure, and heart rate were recorded before and after administration of the intravenous anaesthetic, also at 1, 3, 5 and 10 min after tracheal intubation.

Results

In the control group, significant increases in the haemodynamic parameters were observed during the first 10 min following tracheal intubation (P < 0.05).

Conclusion

Preoperative administration of Lornoxicam attenuates the haemodynamic response to laryngoscopy and tracheal intubation in the elderly.

Keywords

ELDERLYANAESTHESIA, stress responseINTUBATION INTRATRACHEALLORNOXICAM
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 9 , September 2008 , pp. 732 - 736
Copyright
Copyright © European Society of Anaesthesiology 2008

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Footnotes

*

Abstract presented in Euroanaesthesia meeting, Munich, June 2007.

References

1.Balfour, JA, Fitton, A, Barradell, LB. Lornoxicam. A review of its pharmacology and therapeutic potential in the management of painful and inflammatory conditions. Drugs 1996; 51: 639–657.Google Scholar
2.Mason, JL, Hobbs, GJ. Simple method for the analysis of tenoxicam in human plasma using high-performance liquid chromatography. J Chromatogr B Biomed Appl 1995; 665: 410–415.CrossRefGoogle ScholarPubMed
3.Moote, C. Efficacy of non-steroidal anti-inflammatory drugs in the management of postoperative pain. Drug Saf 1993; 9: 380–393.Google Scholar
4.Rosenow, DE, Kreiken, F, Stolke, D, Kursten, FW. Intravenous administration of Lornoxicam, a new NSAID and pethidine for postoperative pain. Clin Drug Investig 1996; 11: 11–19.Google Scholar
5.Rosenow, DE, Albrechtsen, M, Stolke, D. A comparison of patient-controlled analgesia with Lornoxicam versus morphine in patients undergoing lumbar disk surgery. Anesth Analg 1998; 86: 1045–1050.Google ScholarPubMed
6.Smith, JE, Mackenzie, AA, Sanghera, SS et al. Cardiovascular effect of fiberscope-guided nasotracheal intubation. Anaesthesia 1989; 44: 907–910.Google Scholar
7.Kovac, AL. controlling the hemodynamic response to laryngoscopy and endotracheal intubation. J Clin Anesth 1996; 8: 63–79.CrossRefGoogle ScholarPubMed
8.Fassoulaki, A, Kaniaris, P. Does atropine premedication affect the cardiovascular response to laryngoscopy and intubation? Br J Anaesth 1982; 54: 1065–1068.Google Scholar
9.Fassoulaki, A, Kaniaris, P. Intranasal administration of nitroglycerine attenuates the pressor response to laryngoscopy and intubation of the trachea. Br J Anaesth 1983; 55: 49–52.Google Scholar
10.Vucevic, M, Purdy, GM, Ellis, FR. Esmolol hydrochloride for management of cardiovascular stress responses to laryngoscopy and tracheal intubation. Br J Anaesth 1992; 68: 529–530.Google Scholar
11.Ishiyama, T, Kashimoto, S, Oguchi, T et al. Clonidine-ephedrine combination reduces pain on injection of propofol and blunts hemodynamic stress responses during the induction sequence. J Clin Anesth 2006; 18: 211–215.CrossRefGoogle ScholarPubMed
12.Miller, DR, Martineau, RJ, Obrien, H et al. Effects of alfentanil on haemodynamic and catecholamine response to tracheal intubation. Anesth Analg 1993; 76: 1040–1046.CrossRefGoogle ScholarPubMed
13.Freye, E, Levy, JV. Reflex activity caused by laryngoscopy and intubation is obtunded differently by meptazinol, nalbuphine and fentanyl. Eur J Anaesthesiol 2007; 24: 53–58.Google Scholar
14.Habib, AS, Parker, JL, Maguine, AM, Rowbotham, DJ, Thomson, JP. Effects of remifentanil and alfentanil on the cardiovascular response to induction of anesthesia and tracheal intubation in the elderly. Br J Anaesth 2002; 88: 430–433.Google Scholar
15.Harris, CE, Murray, AM, Anderson, JM, Grounds, RM, Morgan, M. Effects of thiopentone, etomidate and propofol on the hemodynamic response to tracheal intubation. Anaesthesia 1988; 43: 32–36.Google Scholar
16.Tsubaki, T, Aono, K, Nakajima, T, Shigematsu, A. Blood pressure, heart rate and catecholamine response during fiberoptic nasotracheal intubation under general anesthesia. J Anesth 1992; 6: 474–479.Google Scholar
17.Kihara, S, Brimacombe, J, Yaguchi, Y et al. Hemodynamic responses among three tracheal intubation devices in normotensive and hypertensive patients. Anesth Analg 2003; 96: 890–895.Google Scholar
18.Shribman, AJ, Smith, G, Achola, KJ. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth 1987; 59: 295–299.Google Scholar
19.Kahl, M, Eberhart, L, Behnke, H et al. Stress response to tracheal intubation in patients undergoing coronary artery surgery: direct laryngoscopy versus an intubating laryngeal mask airway. J Cardiothorac Vasc Anesth 2004; 18: 275–280.Google Scholar
20.Kidd, B, Frenzel, W. A multicenter, randomized, double blind study comparing lornoxicam with diclofenac in osteoarthritis. J Rheumatol 1996; 23: 1605–1611.Google ScholarPubMed
21.Bernstein, RM, Calin, HJ, Calin, A et al. A comparison of the efficacy and tolerability of lornoxicam and indomethacin in ankylosing spondylitis. Eur J Rheumatol Inflamm 1992; 12: 6–13.Google Scholar
22.Straunstrup, H, Ovesen, J, Larsen, U, Elbaek, T, Larsen, U, Kroner, K. Efficacy and tolerability of lornoxicam versus tramadol in postoperative pain. J Clin Pharmacol 1999; 39: 1–8.Google Scholar
23.Ankier, SI, Brimelow, AE, Crome, P et al. Chlortenoxicam pharmacokinetics in young and elderly human volunteers. Postgrad Med J 1988; 64: 752–754.CrossRefGoogle Scholar