This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (7) Citing Articles via Google Scholar Google Scholar Articles by Danou, F. Articles by Fassoulaki, A. Search for Related Content PubMed PubMed Citation Articles by Danou, F. Articles by Fassoulaki, A.

---

REGIONAL ANESTHESIA AND PAIN MEDICINE

The Analgesic Efficacy of Intravenous Tenoxicam as an Adjunct to Patient-Controlled Analgesia in Total Abdominal Hysterectomy

Fotini Danou, MD, DEAA^*, Andia Paraskeva, MD^*, Theodoros Vassilakopoulos, MD, and Argyro Fassoulaki, MD, PhD, DEAA

*Department of Anesthesia, St. Savas Hospital; and Department of Critical Care, Evangelismos Hospital, Athens, Greece

Address correspondence and reprint requests to Fotini Danou, MD, DEAA, 25th March St., No. 30, 15561 Athens, Greece. Address e-mail to fotinidanou{at}yahoo.com

Nonsteroidal antiinflammatory drugs may reduce postoperative opioid consumption. We evaluated the analgesic efficacy of preoperatively administered tenoxicam in patients undergoing total abdominal hysterectomy. Patients were randomly assigned to receive IV either normal saline 4 mL (Group NS), tenoxicam 20 mg (Group T20), or tenoxicam 40 mg (Group T40) before the induction of anesthesia in a double-blinded fashion. Patient-controlled analgesia with fentanyl was used to assess postoperative opioid requirements. Pain was evaluated by visual analog scale at 2, 4, 6, 8, and 24 h postoperatively. Intraoperative bleeding as assessed by the surgeon, incidence of nausea, and gastrointestinal symptoms were recorded. No statistically significant difference was identified between groups in fentanyl consumption or pain scores. The incidence of nausea was similar in all groups. Two patients in Group T20 and two in Group T40 exhibited mild gastrointestinal symptoms. Intraoperative oozing was noted in two patients in Group T40. We conclude that patients undergoing total abdominal hysterectomy and receiving fentanyl via patient-controlled analgesia postoperatively do not benefit from tenoxicam pretreatment. On the contrary, the drug may be associated with an increased incidence of side effects.

Implications: The preoperative administration of 20 or 40 mg IV tenoxicam does not reduce fentanyl consumption via Patient-Controlled Analgesia, compared with placebo, after total abdominal hysterectomy. Additionally, tenoxicam may increase intraoperative bleeding and gastrointestinal side effects.

This article has been cited by other articles:

				F. Bonnet and E. Marret Influence of anaesthetic and analgesic techniques on outcome after surgery Br. J. Anaesth., July 1, 2005; 95(1): 52 - 58. [Abstract] [Full Text] [PDF]

				P. Sigston, D. Yates, S. Leonardi, A. Ng, and G. Smith Use of PCA morphine as the sole analgesic for postoperative pain relief after TAH Br. J. Anaesth., December 1, 2003; 91(6): 923 - 923. [Full Text] [PDF]

				A. Ng, J. Parker, L. Toogood, B. R. Cotton, and G. Smith Does the opioid-sparing effect of rectal diclofenac following total abdominal hysterectomy benefit the patient? Br. J. Anaesth., May 1, 2002; 88(5): 714 - 716. [Abstract] [Full Text] [PDF]