Tenoxicam 20 mg or 40 mg after thoracotomy: a prospective, randomized, double-blind, placebo-controlled study

Area of Science:

• Anesthesiology
• Pharmacology
• Thoracic Surgery

Background:

• Post-thoracotomy pain management remains a clinical challenge.
• Multimodal analgesia strategies are crucial for optimizing patient recovery.
• Non-steroidal anti-inflammatory drugs (NSAIDs) are explored for their analgesic potential in this setting.

Purpose of the Study:

• To evaluate the efficacy and safety of intravenous tenoxicam for managing postoperative pain in patients undergoing thoracotomy.
• To compare the analgesic effects of two different doses of tenoxicam (20 mg and 40 mg) against a placebo.

Main Methods:

• A randomized controlled trial involving 45 adult patients undergoing thoracotomy.
• Patients received placebo, 20 mg IV tenoxicam, or 40 mg IV tenoxicam during chest wall closure.
• All patients received standard analgesia including fentanyl, intercostal blocks, patient-controlled analgesia morphine, and varying epidural infusions.

Main Results:

• Intravenous tenoxicam significantly reduced pain at rest (visual analogue scale) compared to placebo (P<0.05).
• No significant differences in pain reduction were observed between the 20 mg and 40 mg tenoxicam groups.
• No significant differences were found in pain on coughing, opioid consumption, or adverse events between groups.

Conclusions:

• Intravenous tenoxicam 20 mg is effective for managing resting pain following thoracotomy.
• A higher dose of 40 mg tenoxicam did not provide additional analgesic benefit.
• Tenoxicam can be considered as part of a multimodal approach to post-thoracotomy pain management.