Piroxicam versus tenoxicam in spine surgery: a placebo controlled study

In double-blind trial 60 patients undergoing spine surgery were randomized to receive either placebo, tenoxicam 40 mg intravenously (i.v.), tenoxicam 40 mg intramuscularly (i.m.) or piroxicam 40 mg i.m., immediately following the induction of general anesthesia. As compared to placebo, the 24 hour morphine consumption was reduced in all groups. This reduction was only statistically significant (p = 0.023) in the i.v. group (21.7 +/- 11.27 versus 36.53 +/- 20.33 mg). Rest and dynamic pain scores were significantly lower in both tenoxicam groups but more consistently in the i.v. group. With piroxicam only rest pain scores at 24 hours were lower. Less urinary retention was noticed in the i.v. tenoxicam group. This study shows that, following spine surgery, i.v. tenoxicam induces a morphine sparing effect (41%) while offering lower rest and dynamic pain scores and a lower incidence of urinary retention.