Comparison of the therapeutic effects of indomethacin suppository and lornoxicam application before laparoscopic appendectomy

doi:10.3877/cma.j.issn.1674-0793.2023.04.011

Abstract

Abstract:

Objective

To compare the analgesic and anti-inflammatory functions of indomethacin suppository and lornoxicam application before laparoscopic appendectomy (LA).

Methods

One hundred and twenty-eight patients in the Affiliated Beijing Luhe Capital University of Medical Sciences from January to April 2022 were collected for LA with general anesthesia and divided into 2 groups (64 cases in each group) using the random number table method. The drug was administered 30 min before surgery, 100 mg indomethacin suppository was given rectally in group A and 8 mg lornoxicam was administered intravenously in group B. The postoperative analgesic effect, inflammatory indexes, incidence of postoperative adverse effects were compared.

Results

Postoperative VAS score at 0, 3, 6, 12, 18 h (Z=-7.075, -5.455, -3.183,-3.378, -4.113, -4.941, all P<0.01), 24 h postoperative analgesic use, time to postoperative VAS score less than 2, and time to first remedial analgesia (Z=-6.005, -6.540, -6.041, all P<0.000 1) were all improved in group A. There were no statistically significant differences in the reduction of change values of WBC, N%, L%, N/L, CRP, PCT, AIR score, TNF-α, IL-6, IL-8, and IL-10 in both groups compared with those before surgery.

Conclusion

The analgesic effect of applying indomethacin suppository before LA is superior to that of lornoxicam, which can reduce the postoperative fever rate, the anti-inflammatory effect is similar, and no significant adverse effect is observed, with significant therapeutic effect.

Key words: Laparoscopes, Appendectomy, Indomethacin suppository, Lornoxicam, Preoperative analgesia, Anti-inflammatory

Jinhong Gao, Shaolong Hao, Yong Liu, Yibing Weng, Wei Han, Guan Wang, Teng Zhang, Peng Liu, Lei Zhang, Xinyu Zhao. Comparison of the therapeutic effects of indomethacin suppository and lornoxicam application before laparoscopic appendectomy[J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(04): 293-297.

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References 29

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组别	例数	年龄（岁）	性别（男/女，例）	体质量（kg）	发病时长（h）	平均动脉压（mmHg）	术前AIR评分（分）	术前VAS（分）
A组	64	41(31,58)	33/31	68(60,75)	24(12,48)	97.1±13.3	6.4±1.9	6.3±1.9
B组	64	36(29,49)	38/26	66(56,75)	24(2,48)	92.9±10.6	6.2±1.7	5.8±2.0
统计值		-1.478^a	0.791^b	-0.567^a	-0.287^a	1.957^c	0.438^c	1.526^c
P值		0.139	0.374	0.571	0.774	0.053	0.662	0.129

组别	例数	年龄（岁）	性别（男/女，例）	体质量（kg）	发病时长（h）	平均动脉压（mmHg）	术前AIR评分（分）	术前VAS（分）
A组	64	41(31,58)	33/31	68(60,75)	24(12,48)	97.1±13.3	6.4±1.9	6.3±1.9
B组	64	36(29,49)	38/26	66(56,75)	24(2,48)	92.9±10.6	6.2±1.7	5.8±2.0
统计值		-1.478^a	0.791^b	-0.567^a	-0.287^a	1.957^c	0.438^c	1.526^c
P值		0.139	0.374	0.571	0.774	0.053	0.662	0.129

组别	例数	手术时间（min）	术中失血量（ml）	术中丙泊酚用量（mg）	术中舒芬太尼用量（μg）	术中瑞芬太尼用量（μg）	根部缝合（例）	放置引流管（例）	坏疽穿孔（例）
A组	64	40(35,60)	5(5,5)	33(28,41)	20(20,20)	500(398,650)	3	15	7
B组	64	40(30,50)	5(5,5)	30(23,36)	20(15,20)	459(348,720)	0	17	8
统计值		-1.133^a	-2.113^a	-1.710^a	-1.433^a	-0.609^a	-	0.167^b	0.076^b
P值		0.257	0.035	0.087	0.152	0.542	0.244^c	0.683	0.783
	例数	总住院时间（d）	术后首次排气时间（h）	住院费用（元）	术后发热（例）	术后腹泻（例）	术后恶心呕吐（例）
A组	64	2.0(1.3,2.9)	11.5(7.1,16)	13 155(12 351,13 965)	1	3	1
B组	64	2.0(1.3,3.0)	12(9.0,18.0)	12 781 (12 122,16 007)	7	2	3
统计值		-0.002^a	-1.382^a	-0.124^a	3.333^d	0.000^d	0.258^d
P值		0.998	0.167	0.901	0.068	1.000	0.611

组别	例数	手术时间（min）	术中失血量（ml）	术中丙泊酚用量（mg）	术中舒芬太尼用量（μg）	术中瑞芬太尼用量（μg）	根部缝合（例）	放置引流管（例）	坏疽穿孔（例）
A组	64	40(35,60)	5(5,5)	33(28,41)	20(20,20)	500(398,650)	3	15	7
B组	64	40(30,50)	5(5,5)	30(23,36)	20(15,20)	459(348,720)	0	17	8
统计值		-1.133^a	-2.113^a	-1.710^a	-1.433^a	-0.609^a	-	0.167^b	0.076^b
P值		0.257	0.035	0.087	0.152	0.542	0.244^c	0.683	0.783
	例数	总住院时间（d）	术后首次排气时间（h）	住院费用（元）	术后发热（例）	术后腹泻（例）	术后恶心呕吐（例）
A组	64	2.0(1.3,2.9)	11.5(7.1,16)	13 155(12 351,13 965)	1	3	1
B组	64	2.0(1.3,3.0)	12(9.0,18.0)	12 781 (12 122,16 007)	7	2	3
统计值		-0.002^a	-1.382^a	-0.124^a	3.333^d	0.000^d	0.258^d
P值		0.998	0.167	0.901	0.068	1.000	0.611

组别	例数	VAS评分						术后首次补救镇痛时间（h）	术后VAS<2分的时间（h）	术后镇痛药物使用量（mg）
组别	例数	T1	T2	T3	T4	T5	T6	术后首次补救镇痛时间（h）	术后VAS<2分的时间（h）	术后镇痛药物使用量（mg）
A组	64	4(2,4)	2(2,3)	2(2,3)	2(2,2)	2(0,2)	0(0,2)	6.0(2.5,12.5)	3(0,6)	0(0,50)
B组	64	6(4,7)	4(3,5)	4(2,4)	3(2,4)	2(2,2)	2(2,2)	0.5(0.5,0.6)	12(6,18)	50(50,100)
Z值		-7.075	-5.455	-3.183	-3.378	-4.113	-4.941	-6.041	-6.540	-6.005
P值		<0.001	<0.001	0.001	0.001	<0.001	<0.001	<0.001	<0.001	<0.001

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