Canadian Journal of Anaesthesia

, 48:162

Timing of pre-emptive tenoxican is important for postoperative analgesia

  • Deirdre M. O’Hanlon
  • Thavachentham Thambipillai
  • Sallyann T. Colbert
  • Padraic W. Keane
  • H. Fred Given
Regional Anesthesia And Pain


Purpose: In this prospective randomized study, a comparison was made between the efficacy of 20 mg tenoxicam, administered either, 30 min preoperatively or at induction of anesthesia, for the relief of postoperative pain in patients undergoing ambulatory breast biopsy.

Methods. Seventy-three patients were recruited and all received a standard anesthetic consisting of induction with 2 mg·kg−1 propofol followed by 5 µg·kg−1 alfentanyl. No premedication was administered and at the end of the procedure the wounds were infiltrated with 10 ml of bupivacaine (0.5 %). Patients were randomized to receive 20 mg tenoxicam intraveneously either 30 min before surgery or at induction of anesthesia.

Results: Demographic criteria were similar in both groups. There were differences in pain scores at 30, 60, 120 and 240 min postoperatively (VAS at 30 min 3.2±1.2vs 5.5±1.8;P<0.001: VAS at 60 min 1.8±1.2vs 3.7±1.9;P<0.001: VAS at 120 min 0.9±0.9vs 1.7±1.0;P=0. 003: VAS at 240 min 0.5±0.5vs 1.1±0.8;P<0.001: Expressed as mean±SD). There was a difference in the number of patients requiring additional analgesia, in the first four hours postoperatively (12 (33%)vs 27 (73%);P=0.001) and a difference in the time to additional analgesia in these patients (87.5±32.5vs 55.0±26.8 min;P=0.002).

Conclusion: Early administration of pre-emptive tenoxicam 30 min before induction of anesthesia improves postoperative analgesia in patients undergoing ambulatory breast biopsy.


Objectif: Notre étude porte sur la comparaison de l’efficacité de 20 mg de ténoxicam, administrés 30 min avant l’opération ou à l’induction de l’anesthésie pour le soulagement de la douleur postopératoire de patientes qui subissent une biopsie du sein en chirurgie ambulatoire.

Méthode: Nous avons recruté 73 patientes qui ont toutes reçu un régime anesthésique normal constitué d’une induction avec 2 mg·kg−1 de propofol suivi de 5µg·kg−1 d’alfentanil. Aucune prémédication n’a été administrée et, à la fin de l’intervention, 10 ml de bupivacaïne (0,5 %) ont été infiltrés dans la plaie chirurgicale. Les patientes, réparties de façon aléatoire, ont reçu 20 mg de ténoxicam intraveineux, soit 30 min avant l’opération, soit à l’induction de l’anesthésie.

Résultats: Les informations personnelles étaient similaires dans les deux groupes. Les scores de douleur ont été différents pour les mesures réalisées 30, 60, 120 et 240 min après l’opération (selon l’EVA à 30 min 3,2±1,2vs 5,5±1,8;P<0,001: EVA à 60 min 1,8±1,2vs 3,7±1,9;P<0,001: EVA à 120 min 0,9±0,9vs 1,7±1.0;P=0,003: EVA à 240 min 0,5±0,5vs 1,1±0,8;P<0,001: moyenne±écart type). Un nombre différent de patientes a demandé de l’analgésie supplémentaire, pendant les quatre premières heures postopératoires (12 (33 %)vs 27 (73 %);P=0,001). Le temps écoulé avant cette demande d’analgésie diffère également (87,5±32,5vs 55,0±26,8 min;P=0,002).

Conclusion: L’administration précoce de ténoxicam préventif, 30 min avant l’induction de l’anesthésie, améliore l’analgésie postopératoire chez des patientes qui subissent une biopsie du sein en clinique externe.


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Copyright information

© Canadian Anesthesiologists 2001

Authors and Affiliations

  • Deirdre M. O’Hanlon
  • Thavachentham Thambipillai
  • Sallyann T. Colbert
    • 1
  • Padraic W. Keane
    • 1
  • H. Fred Given
    • 1
  1. 1.From the National Breast Cancer Research Institute and Department of Surgery and AnesthesiologyUniversity College HospitalGalwayIreland

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