RESUMO
BACKGROUND AND OBJECTIVES: The aim of this study was to compare the efficacy of 'scheduled' analgesia with analgesia 'on request in patients after craniotomy. PATIENTS AND METHODS: We performed a prospective randomized study comparing 'scheduled' analgesia with analgesia 'on request' on 126 patients aged 16-70 years undergoing craniotomy for a variety of reasons. Patients were randomized to one of two groups; group 1 (68 patients) received lornoxicam 'on request', and group 2 (58 patients) received 8 mg of lornoxicam preoperatively, immediately after intubation, then 8 mg again 6-8 h after the first injection and 8 mg repeated every 8 h for 48 h postoperatively. Subgroup analysis was performed for patients with supratentorial and infratentorial craniotomy. We measured pain scores (visual analogue scale), mean blood pressure and heart rate at 6, 18, 30, 42 and 54 h after surgery and compared differences in these parameters between groups and amongst subgroups. RESULTS AND DISCUSSION: Group 1 visual analogue pain scale scores were significantly higher than those in group 2 (P < 0.05). Group 1 patients with infratentorial craniotomy showed higher pain scores than supratentorial craniotomy patients (P < 0.05). No significant differences were observed in mean blood pressure between groups and subgroups (P > 0.05). We found no correlation between visual analogue scale scores, mean blood pressure and heart rate (P > 0.05). CONCLUSION: 'Scheduled' analgesia with lornoxicam was more effective for treating post-craniotomy pain than 'on request' analgesia with lornoxicam.