Oral tenoxicam for peripheral orthopaedic surgery: a pharmacokinetic study

Non-steroidal anti-inflammatory drugs (NSAIDs) provide effective analgesia after orthopaedic surgery and reduce opioid requirements. The need for parenteral NSAIDs with peripheral surgery is controversial. In this study 10 patients were treated with oral tenoxicam 20 mg preoperatively, and at 4 hours and 28 hours after knee ligament reconstruction surgery. Plasma concentrations of tenoxicam, an NSAID with a long elimination half-life, were measured for 10 days. All patients received patient-controlled intravenous morphine postoperatively, which delayed absorption of the second and third tenoxicam doses. However, plasma concentrations of tenoxicam were achieved and maintained for the five-day surgical admission above the level considered to produce effective analgesia. Oral analgesic administration is a simple and feasible option in the perioperative period.