Blake D W, Bjorksten A R, Libreri F C
Department of Anaesthesia, Royal Melbourne Hospital, Victoria.
Anaesth Intensive Care. 1997 Apr;25(2):142-6. doi: 10.1177/0310057X9702500206.
Non-steroidal anti-inflammatory drugs (NSAIDs) provide effective analgesia after orthopaedic surgery and reduce opioid requirements. The need for parenteral NSAIDs with peripheral surgery is controversial. In this study 10 patients were treated with oral tenoxicam 20 mg preoperatively, and at 4 hours and 28 hours after knee ligament reconstruction surgery. Plasma concentrations of tenoxicam, an NSAID with a long elimination half-life, were measured for 10 days. All patients received patient-controlled intravenous morphine postoperatively, which delayed absorption of the second and third tenoxicam doses. However, plasma concentrations of tenoxicam were achieved and maintained for the five-day surgical admission above the level considered to produce effective analgesia. Oral analgesic administration is a simple and feasible option in the perioperative period.
非甾体抗炎药（NSAIDs）在骨科手术后能提供有效的镇痛作用，并减少阿片类药物的使用需求。对于外周手术使用胃肠外NSAIDs的必要性存在争议。在本研究中，10例患者在膝关节韧带重建手术前、术后4小时和28小时口服替诺昔康20mg。对一种消除半衰期长的NSAIDs——替诺昔康的血浆浓度进行了10天的测定。所有患者术后均接受患者自控静脉注射吗啡，这延迟了第二剂和第三剂替诺昔康的吸收。然而，在为期五天的手术住院期间，替诺昔康的血浆浓度达到并维持在被认为能产生有效镇痛作用的水平之上。口服镇痛药给药在围手术期是一种简单可行的选择。
