PAIN CONTROL AFTER DENTAL SURGERY - A DOUBLE-BLIND, RANDOMIZED TRIAL OF LORNOXICAM VERSUS MORPHINE

Lornoxicam is a new non-steroidal anti-inflammatory drug of the oxicam class. This randomised, double-blind, placebo controlled trial compar ed the analgesic efficacy and tolerability of intramuscular (IM) injec tions of lornoxicam (4, 8, 16 and 20 mg) with morphine (10 and 20 mg) and placebo in 252 patients with mainly moderate to severe pain follow ing surgical removal of an impacted mandibular third molar. Patients t reated with lornoxicam or morphine experienced a significantly greater cumulative pain relief over the 4-h post-injection period (TOTPAR(0-4 )) than placebo recipients. This effect appeared to be dose-dependent, with patients in the lornoxicam 4 mg or morphine 10 mg groups recordi ng significantly lower TOTPAR(0-4) scores than patients in the higher dosage groups of these drugs. No significant difference was detected b etween the morphine 20 mg group and the lornoxicam 8, 16 and 20 mg gro ups. Lornoxicam was well tolerated at all doses and was associated wit h a significantly lower incidence of adverse events than morphine 10 o r 20 mg. Thus, the analgesic efficacy of IM lornoxicam at doses greate r than or equal to 4 mg is superior to placebo, and doses greater than or equal to 8 mg are at least as effective as IM morphine 20 mg. Furt hermore, lornoxicam possesses a more favourable tolerability profile t han morphine and thus represents an attractive alternative for the tre atment of moderate to severe acute pain.