Combination of intra-articular tenoxicam, lidocaine, and pethidine for outpatient knee arthroscopy.
BACKGROUND
Studies of intra-articular non-steroidal anti-inflammatory drugs have revealed an analgesic effect equivalent to that of intra-articular local anaesthetic agents and morphine. The aim of this study was to evaluate the analgesic effect of intra-articular lidocaine, pethidine and tenoxicam compared with that of lidocaine and pethidine on postoperative pain after arthroscopy.


METHODS
After day-case knee arthroscopy, 60 patients were randomly allocated to one of three groups to receive 20 ml of a solution containing 0.9% saline (group S), 2% lidocaine and 10 mg preservative-free pethidine (group LP) and 2% lidocaine, 10 mg preservative-free pethidine and 20 mg tenoxicam (group LPT). Postoperative pain was assessed using a visual analogue scale and measuring analgesic requirements.


RESULTS
Pain scores were significantly lower in the LP group than in the S group at 1 and 2 h after surgery. From 4 h until the end of the first postoperative day, pain scores were significantly lower in the LPT group of patients at rest and on knee flexion than in the other two groups; these patients also used less oral analgesics (P<0.05).


CONCLUSIONS
The combination of 20 ml lidocaine 2%, 10 mg pethidine and 20 mg tenoxicam given intra-articularly provided superior analgesia and reduced oral analgesic requirement during the first day after arthroscopy compared with lidocaine and pethidine alone.
Elhakim
M
M
Department of Anaesthesiology, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
Nafie
M
M
Eid
A
A
Hassin
M
M
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000556:Ambulatory Surgical Procedures; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D001182:Arthroscopy; D004311:Double-Blind Method; D004338:Drug Combinations; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000502:physiology / Q000601:surgery*; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008614:Meperidine / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D010894:Piroxicam / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010919:Placebos; D016059:Range of Motion, Articular
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D010919:Placebos; D010894:Piroxicam; D008012:Lidocaine; D008614:Meperidine; C032801:tenoxicam