Intra-articular Tenoxicam for Postoperative Pain Following Day-Case Arthroscopy

Abstract

In the first part of the clinical study, the analgesic effects of local intra-articular injection of tenoxicam compared with intravenous injection were studied in 60 patients undergoing knee arthroscopy. Intra-articular administration of tenoxicam significantly decreased postoperative pain scores both at rest and during movement, reduced analgesic consumption during 6 hours after surgery, rapid mobilization following operation, reduced incidence of postoperative nausea and vomiting and with insignificant changes in skin bleeding time compared with intravenous tenoxicam group.

The analgesic character of local tenoxicam, which is associated with inhibition of prostaglandin synthesis, block the sensitization of pain receptors to chemical mediators in the inflamed area. These mediators play an important role in hyperalgesia that accompanies postoperative tissue destruction during surgery.

The increase of bleeding time seen with i.v. tenoxicam may not be of clinical significance since none of bleeding time was above the normal upper limit. This may clarify the importance of local administration of tenoxicam in arthroscopic surgery.

In the second part of the present clinical trial, the analgesic character of intra-articular combination of pethidine, lidocaine and tenoxicam (balanced analgesia) compared with pethidine and lidocaine alone were studied in 60 patients undergoing knee arthroscopy under general anesthesia.