Mikkelsen S S, Knudsen K E, Kristensen B B, Linnemann M U, Friis E, Dahl J B
Department of Anesthesiology, Bispebjerg University Hospital, Copenhagen, Denmark.
Anesth Analg. 1996 Dec;83(6):1239-43. doi: 10.1097/00000539-199612000-00019.
We compared wound infiltration with small-dose tenoxicam (7.5 mg) to intramuscular (IM) administration of the same dose to treat pain after herniorrhaphy. In a randomized, double-blind study, 50 patients received either preoperative wound infiltration with tenoxicam, 7.5 mg in 40 mL of 0.9% saline (WI group; n = 25) or IM tenoxicam 7.5 mg (IM group; n = 25). In each group a saline placebo of equal volume was given by the alternate route, i.e., those who received wound infiltration with tenoxicam received 0.75 mL of 0.9% saline IM; those who received IM tenoxicam received 40 mL of 0.9% saline for wound infiltration. Postoperative pain was assessed with a verbal pain scale and a visual analog scale (VAS) at rest and during movement and cough, 1, 2, 4, 6, and 24 h postoperatively. Wound tenderness was assessed with an electronic algometer preoperatively, and 2, 4, and 6 h postoperatively. The need for supplementary analgesics (acetaminophen and morphine) was registered. No differences were observed between groups in VAS pain scores, verbal rating pain scores, pain pressure thresholds, or in need for supplementary analgesics. We conclude that tenoxicam 7.5 mg has no local analgesic effect on postoperative pain after herniorrhaphy.
我们比较了小剂量替诺昔康（7.5毫克）伤口浸润与同等剂量肌肉注射用于治疗疝修补术后疼痛的效果。在一项随机双盲研究中，50例患者要么接受术前替诺昔康伤口浸润（7.5毫克溶于40毫升0.9%盐水中，WI组；n = 25），要么接受替诺昔康7.5毫克肌肉注射（IM组；n = 25）。每组通过交替途径给予等体积的生理盐水安慰剂，即接受替诺昔康伤口浸润的患者接受0.75毫升0.9%生理盐水肌肉注射；接受替诺昔康肌肉注射的患者接受40毫升0.9%生理盐水用于伤口浸润。术后疼痛通过言语疼痛量表和视觉模拟量表（VAS）在术后1、2、4、6和24小时休息、活动及咳嗽时进行评估。术前及术后2、4和6小时用电子痛觉计评估伤口压痛。记录补充镇痛药（对乙酰氨基酚和吗啡）的使用需求。两组在VAS疼痛评分、言语评定疼痛评分、疼痛压力阈值或补充镇痛药需求方面均未观察到差异。我们得出结论，7.5毫克替诺昔康对疝修补术后疼痛无局部镇痛作用。
