Effect of single dose tenoxicam on postoperative epidural analgesia in caeserean section cases

Abstract

Non-steroidal anti-inflammatory drugs are proposed for pre-emptive analgesia. In this study we aimed to investigate the additive effect of single dose systemic tenoxicam when applied preoperatively or peroperatively to patients who had undergone caesarean section (C/S) and were given epidural meperidine for postoperative analgesia. Sixty-seven ASA I patients scheduled to undergo lower segment C/S were divided into three groups randomly. Patients in Group P were given 20 mg tenoxicam intramusculary (i.m.) 3 hours before the operation; patients in Group T were given 20 mg tenoxicam i.m. intraoperatively just after the delivery of the baby and patients in Group K were given saline solution 2 ml. i.m. intraoperatively just after the delivery of the baby. Meperidine was administered for postoperative analgesia at the dose of 25 mg with the volume of 10 ml via epidural catheters in all patients. Meperidine consumptions were noted in the postoperative first 24 hours. Pain was evaluated with Verbal Rating Scale (VRS; 0=no pain, 4=unbearable pain) just before the injection and one hour after the injection of epidural meperidine. Groups were comparable on demografhic variables (p>0.05). Mean meperidine consumption in the first 24 hours was significantly lower in Group P (71.25 ± 23.18 mg) and in Group T (72.61 ± 18.74 mg) than Group K (96.87 ± 24.27 mg), but no difference was observed between Group P and Group T. Change in VRS values that were evaluated before the administration of epidural meperidine and one hour after the intervention was statistically significant within all three groups (p<0.01). However there was no statistically significant difference between all three groups in pain scores at each evaluating time and during 24 hrs as well, (p>0.05). We concluded that single dose tenoxicam does lower the need for opioid use after caesarean operations but pre-emptive administration of the drug was not shown to be superior to perioperative application.