Abstract
Objective: This study is aimed to compare the analgesic effect and safety of preoperative (versus postoperative) meloxicam administration in femoroacetabular impingement (FAI) patients who underwent hip arthroscopy (HA).
 Methods: Totally, 136 FAI patients who scheduled for HA were recruited, then they were randomly assigned to preoperative administration (PREA) group (orally meloxicam 7.5 mg in 12h, 24h before operation, then orally 7.5 mg/d from 12h to Day 7 after operation; N=68) or postoperative administration (POSA) group (orally meloxicam 7.5 mg/d from 12h to Day 7 after operation; N=68) in 1:1 ratio. Furthermore, pain visual analog scale (VAS) score, patient satisfaction score, Harris hip score (HHS) and adverse events were assessed. Besides, the accumulated pethidine consumption for rescuing analgesia was calculated.
 Results: Acute pain VAS score at rest (Day1 – Day2) and pain VAS score at motion (Day1 – Day3) were decreased, meanwhile short-term patient satisfaction score (Day1–Day3) was increased in PREA group compared with POSA group; however, these scores in long-term period were of no difference between PREA group and POSA group (Day3–Month3). Furthermore, accumulated pethidine consumption on Day3 and Day7 were attenuated in PREA group compared with POSA group. Additionally, HHS at any assessed time points (Day7–Month3) did not differ between two groups. Besides, no difference in the incidence of adverse events was found between two groups.
 Conclusions: Preoperative meloxicam administration displays superior efficacy in short-term pain control, patient satisfaction improvement and attenuated consumption of rescue analgesia over postoperative meloxicam administration in FAI patients who underwent HA.
Highlights
Femoroacetabular impingement (FAI) is characterized by abnormal morphology of femoral head–neck or acetabulum that leads to impingement [1, 2]
Totally, 136 femoroacetabular impingement (FAI) patients who scheduled for hip arthroscopy (HA) were recruited, they were randomly assigned to preoperative administration (PREA) group or postoperative administration (POSA) group in 1:1 ratio
Acute pain visual analog scale (VAS) score at rest (Day1 – Day2) and pain VAS score at motion (Day1 – Day3) were decreased, short-term patient satisfaction score (Day1–Day3) was increased in PREA group compared with POSA group; these scores in long-term period were of no difference between PREA group and POSA group (Day3–Month3)
Summary
Femoroacetabular impingement (FAI) is characterized by abnormal morphology of femoral head–neck or acetabulum that leads to impingement [1, 2]. Current treatments for FAI mainly consist of non-operative management (such as rest, physiotherapy and administration of nonsteroidal anti-inflammatory drugs (NSAIDs)) and surgical management (such as open surgery and hip arthroscopy (HA)) [4, 5]. Among these treatments, HA is becoming more popular for it is minimally invasive, which corrects hip shape abnormalities and prevents intraarticular injury [4, 6]. Strong opioid analgesics have been frequently administrated to control postoperative pain; while in minimal invasive surgery (such as HA), weak opioid and NSAIDs are preferred, while their administration are related to several adverse events (such as respiratory suppression, nausea and vomiting) and potential addiction [7]
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