Intra-articular tenoxicam improves postoperative analgesia in knee arthroscopy

Abstract

Intra-articular tenoxicam improves postoperative analgesia in knee arthroscopyPurpose: Non Steroidal Anti-Inflammatory drugs have a well documented benef~ in the relief of postoperative pain. This study was designed to compare the analgesic effect of intra-articular tenoxicam 20 mg with intravenous tenoxicam on postoperative pain in 88 patients undergoing day case knee arthroscopy. Methods: A prospective, double blind, randomized trial was performed. All patients received a standard general anesthetic. Patients in group A received 20 mg tenoxicam made up to 40 ml with normal saline intra-articularly (io) and 2 ml normal saline iv. Patients in group B received 40 ml normal saline intra-articularly and 2 ml, 20 mg of tenoxicam, iv. Results: Both groups of patients were similar with respect to age, weight, sex and tourniquet inflation time. Patients receiving in tenoxicam had lower pain scores (at rest and upon movement) at 30, 60, 120 and 180 min postoperatively (0.8 _ 0.2 vs 2.5 _ 0.2 at rest and 1.24 _+ 0.2 vs 3.4 _+ 0.2 at movement at 60 min; P < 0.000 I). Fewer patients required additional analgesia in the first four hours postoperatively (33% vs 84%; P < 0.0000 I) and the time to first analgesia (23.7 + I 1.2 vs 9.4 _+ 0.6; P < 0.02) was longer in those receiving in tenoxicam. Conclusion: Intra-articular tenoxicam provides superior postoperative analgesia and reduces postoperative analgesic requirements compared with iv tenoxicam in patients undergoing day case knee arthroscopy.Objcctif: Les anti-inflammatoires non st&oi'diens sont des mddicaments bien reconnus pour le soulagement de la douleur postop&atoire. La pr&ente ~tude avait pour but de comparer reffet analg&ique de 20 mg de t6noxi-cam intra-articulaire ~ du t~noxicam intraveineux sur la douleur postop&atoire chez 88 patients admis en chirurgie ambulatoire pour une arthroscopie du genou. M&hode : On a proc6d~ ~ un essai prospectif, randomis6 et ~ double insu. Tous les patients ont re~u un anesth&ique g~n&al standard. Les patients du groupe A ont re~u une injection intra-articulaire (io) compos& de 20 mg de t~noxicam compl6t~ ~ 40 ml par une solution salve et 2 ml de solution sal& iv. Les patients du groupe B ont re~u 40 ml de solution sal& en injection intra-articulaire et 2 ml, 20 mg de t~noxicam, iv. R~sultats : Les deux groupes pr6sentaient des caract&istiques semblables quant ~ I'~ge, le poids, le sexe et le temps de gonflement du garrot. Les patients qui ont re~u du tfinoxicam io ont eu des scores de douleur plus bas (au repos et en mouvement) ~ 30, 60, 120 et 180 min apr~s I'intervention (0,8 + 0,2 vs 2,5 -0,2 au repos et 1,24 _+ 0,2 vs 3,4 _+ 0,2 en mouvement ~ 60 min; P < 0,0001). Moins de patients ont eu besoin d'analg&ie suppl~mentaire pendant les quatre premi&es heures postop&atoires (33 % vs 84 %; P < 0,0000 I) et le temps &oul~ avant la premi&e analg&ie (23,7 _+ I 1,2 vs 9,4 _+ 0,6 P < 0,02) a ~t~ plus long pour les patients qui ont re~u du t~noxicam in. Conclusion : Le t6noxicam intra-articulaire, compar~ au t~noxicam iv, fournit une anal...

Intra-articular injection of tenoxicam following temporomandibular joint arthrocentesis: a pilot study

“…An ideal agent should be active on cessation of surgery, have a prolonged duration of action, be easy to administer and have no serious side effects 4 .…”

Intraarticular analgesia after arthroscopic knee surgery: comparison of neostigmine, clonidine, tenoxicam, morphine and bupivacaine

“…The third drug we administered is tenoxicam, a NSAID which has been used in studies intraarticularly, alone or in combination with local anaesthetics [8][9][10][11][12][13]. It has been shown that i.a tenoxicam provided superior postoperative analgesia and reduced analgesic requirements compared to intravenous tenoxicam indicating a peripheral analgesic effect [11,13].…”

Postoperative Pain and Other Acute Pain Syndromes

“…333 Tenoxicam, 20 mg, has been used successfully both as a sole intra-articular analgesic and as an adjunct in combination therapy. 334,335 …”