Mg Of Tenoxicam Research Articles

Perfusion index versus visual analogue scale: as an objective tool of renal colic pain in emergency department

BackgroundPerfusion index (PI) has use to monitor sympathetic response changes to pain. In this study, we aimed to evaluate the utility of using perfusion index as an objective marker of pain relief and of the need for rescue analgesia in ED patients with documented renal colic. MethodsWe conducted a prospective observational study between January 2020 and December 2020. The demographic characteristics of the patients, their complaints, nephrolithiasis histories, vital signs, PI, and VAS scores (on admission and after treatment) were recorded. ResultsA total of 144 patients were included. All patients were administered 20 mg of Tenoxicam on admission. There was a statistically significant difference between the PI (<0.001) and VAS scores (<0.001) on admission and after the administration of Tenoxicam. 43.1% (n = 62) of the patients needed rescue analgesia. Accordingly to ROC curve, the ability of both PI2 (AUC: 0.615, 95%CI 0.519–0.711, p = 0.018) and ΔPI (AUC: 0.601, 95%CI 0.508–0.694, p = 0.039) indices were determined as statistically significant. The cutoff value of the PI2 level for the prediction of the needed rescue analgesia was 4.65 and the cutoff value for ΔPI (PI2-PI1) was 2. All patients had a pain VAS score of <3 and a mean PI of 5.7 ± 2.9 at discharge from the emergency department. ConclusionIn patients presenting to the emergency department with renal colic, the PI value on admission and after analgesic therapy can be helpful in assessing the severity of pain and predict the need for rescue analgesia.

Effectiveness of the tenoxicam in patients with ankylosing spondylitis

To study the changes in pain syndrome and its characteristic in patients with ankylosing spondylitis (AS) who received tenoxicam after non-effective treatment with NSAIDs on the 'on-demand' basis. Forty patients with AS, who had BASDAI ≥4.0 at baseline and after 52 weeks of NSAIDs on the 'on-demand' basis, were randomized into 2 groups: 30 patients were prescribed 20 mg of tenoxicam oraly per day, 10 patients continued previous therapy. The BASDAI, ASDAS indices were calculated in 52 and 56 weeks. BASDAI and ASDAS indices decreased in patients treated with tenoxicam, the AS activity in patients with on-demand NSAID intake did not change. The change of the ineffective long-term NSAID intake in the 'on-demand' basis to permanent drug intake was associated with a rapid (within 4 weeks) decrease in the clinical activity of ankylosing spondylitis.

The Analgesic Effects of Morphine and Tramadol Added to Intra-articular Levobupivacaine-Tenoxicam Combination for Arthroscopic Knee Surgery on Postoperative Pain; a Randomized Clinical Trial.

Background:Arthroscopic knee surgery is commonly performed as an outpatient procedure and is often associated with postoperative pain.Objectives:We aimed to compare the effects of intra-articular levobupivacaine-tenoxicam-tramadol and levobupivacaine-tenoxicam-morphine combinations on postoperative pain in patients undergoing elective arthroscopic knee surgery.Materials and Methods:A total of 90 ASA I-II patients undergoing elective arthroscopic meniscectomy under general anesthesia were enrolled. The participants were randomly allocated to three groups to receive the following intra-articular medications after completion of the surgery and before deflation of the tourniquet: Group S, 20 mL of saline; Group T, 35 mg of levobupivacaine, 20 mg of tenoxicam, and 100 mg of tramadol in 20 mL saline; and Group M, 35 mg of levobupivacaine, 20 mg of tenoxicam, and 4 mg of morphine in 20 mL saline. Visual analogue scale values at rest (VASr) and at active flexion of knee (VASa) at postoperation hours 1, 2, 4, 8, 12, and 24, duration of analgesia, total analgesic consumption, and number of rescue analgesia at 24 hours were evaluated.Results:VASr and VASa were significantly higher in group S in comparison to other groups (P < 0.05). Duration of analgesia was significantly longer in Group T and Group M than in Group S (P < 0.05). The difference between group T and group M was also significant (P < 0.05). Number of rescue analgesia and total analgesic consumption at postoperative hour 24 was significantly fewer in group M compared with other groups (P < 0.05).Conclusions:Intra-articular levobupivacaine-tenoxicam-morphine combination provides effective pain relief, longer analgesic duration, and less analgesic requirement when compared with intra-articular levobupivacaine-tenoxicam-tramadol combination and saline after knee arthroscopic surgery.

The next step in the treatment of persistent temporomandibular joint pain following arthrocentesis: A retrospective study of 18 cases

Temporomandibular joint disorders affect a big portion of the population. There are a variety of treatment methods currently in use. Conservative treatment modalities are followed by more invasive approaches like arthrocentesis or arthroscopy. The aim of the study is to compare the effects of intra-articular tenoxicam injection and arthrocentesis plus viscosupplementation on patients in which a previous arthrocentesis plus viscosupplementation has failed to relieve pain and restore function. The study group consists of 18 TMJs in 16 patients (15 female and 1 male) and the patients were randomly divided into two groups as the arthrocentesis plus viscosupplementation group (n: 8) and tenoxicam injection (n: 10). 20 mg of tenoxicam was injected to the upper compartments of 10 joints without arthrocentesis. The other 8 joints were treated with a second arthrocentesis and sodium hyaluronate injection. VAS scores and maximum mouth opening with and without assistance were recorded in the post operative first week, first month and third month. The results show that there is little benefit in using relatively conservative methods once an arthrocentesis together with viscosupplementation has failed to relieve the patients pain. It is concluded that more invasive procedures should be considered for the patients who do not benefit from arthrocentesis.

Effectiveness of tenoxicam and ibuprofen for pain prevention following endodontic therapy in comparison to placebo: a randomized double-blind clinical trial

Tenoxicam is an effective analgesic and anti-inflammatory agent for symptomatic treatment of various conditions. The purpose of this study was to evaluate clinically the effectiveness of prophylactic tenoxicam and prophylactic ibuprofen in reducing post-endodontic pain compared with placebo. A total of 48 patients consented to a double-blind, single dose, prophylactic oral administration of 20 mg of tenoxicam, 200 mg of ibuprofen, or a placebo before root canal treatment. The root canal treatment was performed in one visit. The patients registered their degree of discomfort on a 100-mm visual analog scale, immediately postoperative, and 6, 12, 24, 48 and 72 h after initiation of root canal treatment. The two-way ANOVA test and Tukey HSD post hoc test showed that in the 6-h period, both 20 mg of tenoxicam and 200 mg of ibuprofen provided significantly better pain relief than the placebo. Prophylactic administration of a single dose of 20 mg tenoxicam or 200 mg ibuprofen before RCT provides an effective reduction at 6 h (P < 0.05). Because of the advantages of tenoxicam, it may be useful as a prophylactic analgesic when post-endodontic pain is anticipated.

Epidural versus intravenous fentanyl for postoperative analgesia following orthopedic surgery: randomized controlled trial.

Controversy exists regarding the site of action of fentanyl after epidural injection. The objective of this investigation was to compare the efficacy of epidural and intravenous fentanyl for orthopedic surgery. A randomized double-blind study was performed in Hospital São Paulo. During the postoperative period, in the presence of pain, 29 patients were divided into two groups: group 1 (n = 14) received 100 microg of fentanyl epidurally and 2 ml of saline intravenously; group 2 (n = 15) received 5 ml of saline epidurally and 100 microg of fentanyl intravenously. The analgesic supplementation consisted of 40 mg of tenoxicam intravenously and, if necessary, 5 ml of 0.25% bupivacaine epidurally. Pain intensity was evaluated on a numerical scale and plasma concentrations of fentanyl were measured simultaneously. The percentage of patients who required supplementary analgesia with tenoxicam was lower in group 1 (71.4%) than in group 2 (100%): 95% confidence interval (CI) = 0.001-0.4360 (P = 0.001, Fisher's exact test; relative risk, RR = 0.07). Epidural bupivacaine supplementation was also lower in group 1 (14.3%) than in group 2 (53.3%): 95% CI = 0.06-1.05 (P = 0.03, Fisher's exact test; RR = 0.26). There was no difference in pain intensity on the numerical scale. Mean fentanyl plasma concentrations were similar in the two groups. Intravenous and epidural fentanyl appear to have similar efficacy for reducing pain according to the numerical scale, but supplementary analgesia was needed less frequently when epidural fentanyl was used. NCT00635986.

A double-blind randomised controlled study comparing subacromial injection of tenoxicam or methylprednisolone in patients with subacromial impingement

We have carried out a prospective double-blind randomised controlled trial to compare the efficacy of a single subacromial injection of the non-steroidal anti-inflammatory drug, tenoxicam, with a single injection of methylprednisolone in patients with subacromial impingement. A total of 58 patients were randomly allocated into two groups. Group A received 40 mg of methylprednisolone and group B 20 mg of tenoxicam as a subacromial injection along with lignocaine. The Constant-Murley shoulder score was used as the primary outcome measure and the Disability of Arm, Shoulder and Hand (DASH) and the Oxford Shoulder Score (OSS) as secondary measures. Six weeks after injection the improvement in the Constant-Murley score was significantly greater in the methylprednisolone group (p = 0.003) than in the tenoxicam group. The improvement in the DASH score was greater in the steroid group and the difference was statistically significant and consistent two (p < 0.01), four (p < 0.01) and six weeks (p < 0.020) after the injection. The improvement in the OSS was consistently greater in the steroid group than in the tenoxicam group. Although the difference was statistically significant at two (p < 0.001) and four (p = 0.003) weeks after the injection, it was not at six weeks (p = 0.055). Subacromial injection of tenoxicam does not offer an equivalent outcome to subacromial injection of corticosteroid at six weeks. Corticosteroid is significantly better than tenoxicam for improving shoulder function in tendonitis of the rotator cuff after six weeks.

Comparative study on two rapid and sensitive methods for quantitative determination of tenoxicam in tablets

Tenoxicam, a piroxicam analogue, is an NSAID (Non-Steroid Antinflamatory Drug). It is used in the symptomatic management of musculoskeletal and joint disorders such as osteoarthritis and rheumatoid arthritis, and also in the short-term management of soft-tissue injury. Its quantitative determination in pharmaceutical formulations is important to guarantee the desired therapeutic effects. The objective of this research was to develop, validate and compare spectrophotometric and chromatographic methods in the quantitative determination of tenoxicam in tablet preparations. In this work, tablets containing 20.0 mg of tenoxicam from different origins were analyzed. The spectrophotometric method was validated using 0.1 mol/L NaOH as solvent and a signal at 368 nm was taken. The HPLC method was validated using Synergi Hydro-RP® C18 column (250x4.6 mm, 4 µm). The mobile phase was constituted of methanol-water (61:39 v/v) with pH adjusted to 2.5 with formic acid, at a flow rate of 1.0 mL/min. UV detection was made at 375 nm. All analyses were performed with a column temperature of 25 °C ± 1. The calibration curves were linear over a concentration range from 4.0-24.0 µg/mL with a correlation coefficient better than 0.9999. The detection limit (DL) and quantitation limit (QL) were 0.25 µg/mL and 0.90 µg/mL for UV method and 0.35 µg/mL and 1.20 µg/mL for HPLC method respectively. The intra-day and inter-day precision expressed as RSD were below 2% for both methods. The mean recovery of tenoxicam was found to be in the range of 98.5-101.25% for UV method and 99.01-101.93% for HPLC method. The UV and HPLC methods were found to be rapid, precise and accurate. Statistically there was no significant difference between proposed UV spectrophotometric and HPLC methods.

Administração intraperitoneal da mistura com excesso enantiomérico de 50% de bupivacaína (S75-R25) para analgesia pós-operatória em colecistectomias videolaparoscópicas

The analgesic effect of intraperitoneal administration of local anesthetics after laparoscopic cholecystectomy is a controversial issue, and the results described vary from considerable pain relief to little reduction in pain. The objective of this study was to evaluate the efficacy of the intraperitoneal administration of 50% enantiomeric excess bupivacaine (S75-R25) for the postoperative pain relief of laparoscopic cholecystectomy. A randomized, double blind, placebo controlled study was conducted with 40 patients undergoing laparoscopic cholecystectomy, who were divided in two groups: GI (n = 20) received 80 mL of intraperitoneal 0,125% S75-R25 bupivacaine at the end of the procedure; and GII (n = 20) received 80 mL of intraperitoneal normal saline. Both groups received 40 mg of tenoxicam and 30 mg.kg-1 of intravenous dypirone shortly before the end of the surgery. Tramadol was used for postoperative analgesia (PO). Pain scores were evaluated at rest, sitting up, and during the Valsalva maneuver, according to a numeric scale upon waking up and 2, 4, 8, 12, and 24 hours postoperatively; the presence of shoulder pain was assessed, as well as the length of time until the first request of analgesic and its cumulative consumption. There was a statistically significant difference in resting pain scores at 12 hours PO (GI < GII). The length of time until the first request of tramadol was greater in GI and this group presented smaller consumption of this drug, but these differences were not statistically significant. The intraperitoneal instillation of 80 mL of 0.125% S75-R25 bupivacaine provided for lower resting pain scores, which was statistically significant only at the 12th postoperative hour.

Comparing analgesic effect of intra-articular neostigmine, tramadol and tenoxicam with placebo

Abstract Purpose: To compare post-operative analgesic effects of intra-articular (i.a.) drugs. Methods: After the approval of ethic committee, a randomized study on 68 patients undergoing knee arthroscopy was performed. In Group I (n = 16) 0.5 mg of neostigmine, in Group II (n = 14) 100 mg of tradamol, in Group III (n = 20) 20 mg of tenoxicam in 20 ml 0.9% NaCl solution and Group P (n = 18) 20 ml of 0.9% NaCl were injected i.a. at the end of the arthroscopy. The visual analogue scale, heart rate (HR), mean arterial pressure (MAP) values and side effects were recorded at intervals of 1, 2, 6 and 24 hours after the operation. Patient's satisfaction was also recorded. Results: The duration of analgesia in Group I was significantly longer than in the other groups. In Group III patients' satisfaction was excellent. One patient in Group I and Group II had nausea, one patient in Group II had somnolence. Conclusion: All drugs provided acceptable post-operative analgesia with excellent satisfaction in Group III. A...

Intramuscular tenoxicam to treat acute renal colic

To study the possible therapeutic effects on acute renal colic of a single 20 mg intramuscular dose of tenoxicam. The study comprised 30 patients (22 men and eight women, mean age 32 years, range 17-60) who presented with acute renal colic and were diagnosed by intravenous urography, a general urine examination and ultrasonography. Each patient was treated with 20 mg of tenoxicam given intramuscularly. The severity of pain was assessed on a verbal six-point scale. Twenty-four patients markedly improved within 1 h of receiving tenoxicam (P < 0.001). No side-effects were reported and the drug was tolerated well by all the patients. Tenoxicam can be used successfully to treat acute renal colic.

Bioavailability of intramuscularly administered tenoxicam

Bioavailability of intramuscularly administered tenoxicam relative to single oral and relative to intravenous doses was determined in two separate randomized crossover studies. Twelve healthy volunteers (12 males, age 20-30 years) received a rapid intravenous injection and a single intramuscular dose and 12 other subjects (11 males, 1 female, age 21-25 years) a single oral and a single intramuscular dose of 20 mg of tenoxicam on two different occasions. The wash-out period between the two consecutive treatments was 4 weeks. Plasma concentrations after dosing were determined by a specific HPLC method. Differences in tenoxicam concentration-time profiles after the different routes of administration were limited to the first 2 h after dosing. Later, plasma concentrations were almost superimposable within and across the two studies. The extent of absorption of intramuscularly administered tenoxicam was complete (mean +/- CV per cent: F(abs) 0.99 +/- 20 per cent) with no difference between the two extravascular administrations (F(rel) 0.95 +/- 10 per cent, intramuscular vs oral). After intramuscular administration tenoxicam was more rapidly absorbed compared to the oral dose (Tmax 0.71 h +/- 80 per cent vs 1.4 h +/- 62 per cent; p > 0.05). Peak concentrations after oral and intramuscular administration (Cmax 2.5 mg l-1 +/- 19 per cent vs 2.7 mg l-1 +/- 14 per cent; p < 0.05) were very similar.

Nonsteroidal antiinflammatory drug therapy in rheumatoid arthritis patients. Lack of association between clinical improvement and effects on sleep

Thirteen patients with rheumatoid arthritis (mean +/- SD age 55.8 +/- 10.5 years) received 20 mg of tenoxicam daily for 90 days following a 3-7 day "washout" period and 4 days of placebo treatment. Clinical evaluations were conducted at the end of the washout period and at monthly intervals thereafter. All-night polysomnography was performed in a sleep laboratory during the last 2 days of placebo treatment and on days 13, 14, 89, and 90 of tenoxicam treatment. Although there was improvement in the patients' clinical condition, there were no treatment-related changes in any of the sleep parameters. Eight of the 13 patients, however, were found to have primary sleep disorders. Four had periodic leg movements during sleep, 3 had sleep apneas, and 1 had a combination of both disorders. The implications of these findings in the treatment of sleep disorders in patients with rheumatoid arthritis are discussed.

Measurement of renal functions by double isotope techniques in elderly patients during tenoxicam therapy

Four elderly patients (aged 68–87 yr) with osteoarthritis were treated with 20 mg of tenoxicam (a new non-steroidal anti-inflammatory drug) daily for at least 12 weeks. Tenoxicam did not appear to have any harmful effect on glomerular filtration rate and effective renal plasma flow, as measured by a single intravenous injection of 51Cr-EDTA and 125I-iodohippurate. Plasma concentration of tenoxicam indicated good compliance, and no evidence of unexpected accumulation of tenoxicam in the plasma was observed during 12 weeks of medication.