British Journal of Anaesthesia, Vol 78, Issue 2 163-168, Copyright © 1997 by The Board of Management and Trustees of the British Journal of Anaesthesia
T. M. Cook, J. P. Tuckey and J. P. Nolan
Arthroscopy of the knee is performed regularly on a day-case basis.
Intra-articular bupivacaine produces transient analgesia and reports of
analgesia using intra-articular morphine have produced conflicting results.
Non-steroidal anti-inflammatory drugs given systemically can provide
effective analgesia for this procedure. In this study we attempted to
determine if intra-articular tenoxicam provided useful analgesia after
day-case arthroscopy. Sixty three ASA I-II patients were allocated randomly
to one of three groups to receive 40 ml of a solution containing 0.9%
saline (group Pla), 0.25% bupivacaine (group Bup) or tenoxicam 20 mg (group
Ten). The injection was made into the knee joint at the end of surgery, 10
min before tourniquet deflation. Verbal rating and visual analogue pain
scores (at rest and on knee flexion), use of analgesia, mobilization and
disturbance by pain at home were recorded for the next 48 h. There were no
differences between pain scores in any of the three groups when tested at
rest or on movement. Less analgesia was used in the first 24 h by patients
in the tenoxicam group but the difference in time to first analgesia was
not statistically significant. Side effects and disturbance by pain were
similar in all groups. The use of intra-articular tenoxicam 20 mg at the
end of arthroscopy reduced oral analgesic requirements during the first day
after operation but did not alter patients' perception of pain.
CLINICAL INVESTIGATIONS
Analgesia after day-case knee arthroscopy: double-blind study of intra- articular tenoxicam, intra-articular bupivacaine and placebo
Royal United Hospital, Combe Park, Bath; Bristol Royal Infirmary, Bristol
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