Abstract
This study aimed to compare the analgesic effect, patients’ satisfaction, tolerance and hip-joint function recovery by preoperative meloxicam versus postoperative meloxicam in treating hip osteoarthritis (OA) patients receiving total hip arthroplasty (THA). 132 hip OA patients who underwent THA surgery were allocated into postoperative analgesia (POST) and preoperative analgesia (PRE) groups at a 1:1 ratio. In the PRE group, patients took meloxicam 15 mg at 24 h pre-operation, 7.5 mg at 4 h, 24 h, 48 h and 72 h post-operation; in the POST group, patients received meloxicam 15 mg at 4 h post-operation, then 7.5 mg at 24 h, 48 h and 72 h post-operation. Furthermore, postoperative pain, consumption of patient-controlled analgesia (PCA), overall satisfaction and adverse events were evaluated within 96 h post-operation; meanwhile, Harris hip score was assessed within 6 months post-operation. Pain VAS at rest at 6 h, 12 h, 24 h, and pain VAS at passive movement at 6 h, 12 h were decreased in PRE group compared to POST group. In addition, additional consumption of PCA and the total consumption of PCA were both reduced in PRE group compared to POST group. Additionally, overall satisfaction in PRE group was higher at 24 h, 48 h and 72 h compared to POST group. While Harris hip score was of no difference between POST group and PRE group at M3 or M6. Besides, no difference in adverse events incidence was found between the two groups. In conclusion, preoperative meloxicam achieves better efficacy and similar tolerance compared to postoperative meloxicam in hip OA patients post THA.
Highlights
Osteoarthritis (OA) is a common degenerative joint disease and is one of the most predominant causes of pain and physical inactivity in the worldwide population (Aresti et al 2016; Skou et al 2019)
The findings illustrated that in hip OA patients who received total hip arthroplasty (THA), compared to postoperative meloxicam: (a) preoperative meloxicam was superior at reducing pain visual analogue scale score (VAS) at rest and pain VAS at passive movement; in addition, it decreased additional and total consumption of patient-controlled analgesia (PCA); (b) preoperative meloxicam elevated overall satisfaction; (c)
Meloxicam has been used for postoperative pain control for a long time, mostly in patients with arthritis, the preoperative use of meloxicam has been elucidated by several studies as a non-inferior modality compared to postoperative meloxicam for controlling the pain in patients with osteoarthritis post-surgery
Summary
Osteoarthritis (OA) is a common degenerative joint disease and is one of the most predominant causes of pain and physical inactivity in the worldwide population (Aresti et al 2016; Skou et al 2019). Intravenous patient-controlled analgesia (PCA) is commonly applied for postoperative pain control in hip OA patients who receive THA, and several analgesics are frequently applied in PCA, such as the opioid drugs (Fan et al 2018). Excessive use of PCA may contribute to opioid drug overuse, which subsequently results in several adverse events, for instance, nausea and vomiting. Thereby, in hip OA patients who undergo THA, it is of note to explore a treatment strategy to achieve sufficient pain control and reduced adverse events at the same time. A kind of NSAIDs, contributes a lot to the pain control in many diseases related to arthritis with good efficacy and tolerance (Park et al 2014; Ruperto et al 2005). The efficacy of preoperative meloxicam for relieving pain in hip OA patients receiving THA is still unclear
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