Abstract
This study aimed to compare the efficacy and safety of very early preemptive meloxicam, early preemptive meloxicam, and postoperative meloxicam administration for postoperative pain relief in patients undergoing arthroscopic knee surgery (AKS). Three hundred and six patients about to receive AKS were consecutively enrolled in this randomized, controlled study and randomly allocated into three groups: very early analgesia (VEA) group, early analgesia (EA) group, and postoperative analgesia (PA) group. Pain visual analog scale (VAS) score at rest and at flexion, patient global assessment (PGA) score, consumption of rescue pethidine, and adverse events (AEs) were assessed. Pain VAS score and severity at rest/flexion were all decreased in the VEA group compared with EA group and PA group at 4 h post-operation and were also reduced in the VEA and EA groups compared with the PA group at 8 h and 12 h post-operation. PGA score was lower in the VEA group compared with the EA group and PA group at 4 h post-operation, and was attenuated in the VEA group and the EA group compared with the PA group at 8 h, 12 h, and 24 h post-operation as well. Consumption of rescue pethidine was less in the VEA group than that in the PA group. In addition, no difference in the incidence of AEs was found among the VEA, EA, and PA groups. In conclusion, preemptive meloxicam is more effective in postoperative pain control and equally tolerated compared with postoperative meloxicam in patients receiving AKS.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Aoki T et al (2006) Premedication with cyclooxygenase-2 inhibitor meloxicam reduced postoperative pain in patients after oral surgery. Int J Oral Maxillofac Surg 35:613–617. https://doi.org/10.1016/j.ijom.2006.01.026
Attur M et al (2015) Plasma levels of interleukin-1 receptor antagonist (IL1Ra) predict radiographic progression of symptomatic knee osteoarthritis. Osteoarthr Cartil 23:1915–1924. https://doi.org/10.1016/j.joca.2015.08.006
Garcia-Rayado G, Navarro M, Lanas A (2018) NSAID induced gastrointestinal damage and designing GI-sparing NSAIDs. Expert Rev Clin Pharmacol 11:1031–1043. https://doi.org/10.1080/17512433.2018.1516143
Hashemi SJ, Soltani H, Heidari SM, Rezakohanfekr M (2013) Preemptive analgesia with intra-articular pethidine reduces pain after arthroscopic knee surgery. Adv Biomed Res 2:9. https://doi.org/10.4103/2277-9175.107971
Hussain SA, Marouf BH, Ali ZS, Ahmmad RS (2018) Efficacy and safety of co-administration of resveratrol with meloxicam in patients with knee osteoarthritis: a pilot interventional study. Clin Interv Aging 13:1621–1630. https://doi.org/10.2147/CIA.S172758
Karamanlioglu B, Alagol A, Turan FN (2005) Preemptive oral rofecoxib plus postoperative intraarticular bupivacaine for pain relief after arthroscopic knee surgery. Agri 17:29–33
Liu J, Wang F (2018) Preoperative celecoxib analgesia is more efficient and equally tolerated compared to postoperative celecoxib analgesia in knee osteoarthritis patients undergoing total knee arthroplasty: a randomized, controlled study. Medicine (Baltimore) 97:e13663. https://doi.org/10.1097/md.0000000000013663
Mardani-Kivi M, Karimi Mobarakeh M, Haghighi M, Naderi-Nabi B, Sedighi-Nejad A, Hashemi-Motlagh K, Saheb-Ekhtiari K (2013) Celecoxib as a pre-emptive analgesia after arthroscopic knee surgery; a triple-blinded randomized controlled trial. Arch Orthop Trauma Surg 133:1561–1566. https://doi.org/10.1007/s00402-013-1852-0
Min S et al (2017) Serum levels of the bone turnover markers dickkopf-1, osteoprotegerin, and TNF-alpha in knee osteoarthritis patients. Clin Rheumatol 36:2351–2358. https://doi.org/10.1007/s10067-017-3690-x
Onda A, Ogoshi A, Itoh M, Nakagawa T, Kimura M (2016) Comparison of the effects of treatment with celecoxib, loxoprofen, and acetaminophen on postoperative acute pain after arthroscopic knee surgery: a randomized, parallel-group trial. J Orthop Sci 21:172–177. https://doi.org/10.1016/j.jos.2015.11.005
Ong KS, Seymour RA, Tan JM (2004) A prospective randomized crossover study of the preemptive analgesic effect of nitrous oxide in oral surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98:637–642. https://doi.org/10.1016/S1079210404001878
Orozco-Solis M, Garcia-Avalos Y, Pichardo-Ramirez C, Tobias-Azua F, Zapata-Morales JR, Aragon-Martinez OH, Isiordia-Espinoza MA (2016) Single dose of diclofenac or meloxicam for control of pain, facial swelling, and trismus in oral surgery. Med Oral Patol Oral Cir Bucal 21:e127–e134
Pavlin DJ, Chen C, Penaloza DA, Buckley FP (2004) A survey of pain and other symptoms that affect the recovery process after discharge from an ambulatory surgery unit. J Clin Anesth 16:200–206. https://doi.org/10.1016/j.jclinane.2003.08.004
Reuben SS, Sklar J, El-Mansouri M (2001) The preemptive analgesic effect of intraarticular bupivacaine and morphine after ambulatory arthroscopic knee surgery. Anesth Analg 92:923–926
Singla N et al (2018) Efficacy and safety of intravenous meloxicam in subjects with moderate-to-severe pain following abdominoplasty. Plast Reconstr Surg Glob Open 6:e1846. https://doi.org/10.1097/GOX.0000000000001846
Solheim N, Gregersen I, Halvorsen B, Bjerkeli V, Stubhaug A, Gordh T, Rosseland LA (2018) Randomized controlled trial of intra-articular ketorolac on pain and inflammation after minor arthroscopic knee surgery. Acta Anaesthesiol Scand 62:829–838. https://doi.org/10.1111/aas.13104
Tuncer B, Babacan A, Arslan M (2007) Preemptive intraarticular tramadol for pain control after arthroscopic knee surgery. Agri 19:42–49
Uribe AA, Arbona FL, Flanigan DC, Kaeding CC, Palettas M, Bergese SD (2018) Comparing the efficacy of IV ibuprofen and ketorolac in the management of postoperative pain following arthroscopic knee surgery. A randomized double-blind active comparator pilot study. Front Surg 5:59. https://doi.org/10.3389/fsurg.2018.00059
Zhou F, Du Y, Huang W, Shan J, Xu G (2017) The efficacy and safety of early initiation of preoperative analgesia with celecoxib in patients underwent arthroscopic knee surgery: a randomized, controlled study. Medicine (Baltimore) 96:e8234. https://doi.org/10.1097/md.0000000000008234
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no competing interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Yuan, Y., Cui, D. & Zhang, Y. Preemptive meloxicam achieves a better effect on postoperative pain control and similar tolerance compared with postoperative meloxicam in patients receiving arthroscopic knee surgery. Inflammopharmacol 27, 1091–1100 (2019). https://doi.org/10.1007/s10787-019-00614-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10787-019-00614-4