Efficacy and tolerability of lornoxicam versus tramadol in postoperative pain

This randomized double-blind study compared the analgesic efficacy and tole rability of intramuscular lornoxicam and tramadol in 76 patients with moder ate to unbearable pain following arthroscopic reconstruction of the anterio r cruciate ligament using the patella bone-tendon-bone technique. patients receiving a single dose of lornoxicam 16 mg experienced significantly great er total pain relief than patients receiving tramadol 100 mg over the follo wing 8 hours. Lornoxicam had greater analgesic efficacy than tramadol in pa tients with moderate baseline pain but was of equivalent efficacy in those with severe/unbearable baseline pain. Fewer patients in the lornoxicam grou p required rescue medication (58% vs. 77%, respectively). Patients' global impression of efficacy showed lornoxicam to be superior to tramadol with 82 % and 49% of patients, respectively, rating treatment as good, very good, o r excellent. Following multiple-dose administration of lornoxicam (8 mg tid ) or tramadol (100 mg tid) for 3 days, efficacy profiles similar to those f ollowing a single dose were obtained. Thus, slightly fewer patients in the lornoxicam group required rescue medication, and patients' global impressio n of efficacy again favored lornoxicam. Adverse events were reported by 38 of the 76 patients and were mainly mild to moderate in severity. Significan tly fewer patients reported one or more adverse events with lornoxicam than with tramadol (14 vs. 24, respectively). Thus, intramuscular lornoxicam of fers a useful alternative to tramadol for the treatment of moderate to seve re postoperative pain. Journal of Clinical Pharmacology, 1999;39:834-841 (C ) 1999 the American College of Clinical Pharmacology.