Combination of intra-articular tenoxicam, lidocaine, and pethidine for outpatient knee arthroscopy

Background: Studies of intra-articular non-steroidal anti-inflammatory drug s have revealed an analgesic effect equivalent to that of intra-articular l ocal 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 allocat ed to one of three groups to receive 20 mi of a solution containing 0.9% sa line (group S), 2% lidocaine and 10 mg preservative-free pethidine (group L P) 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 Ih until the end of the first posto perative day, pain scores were significantly lower in the LPT group of pati ents at rest and on knee flexion than in the other two groups; these patien ts also used less oral analgesics (P<0.05). Conclusion: The combination of 20 mi lidocaine 2%, 10 mg pethidine and 20 m g tenoxicam given intra-articularly provided superior analgesia and reduced oral analgesic requirement during the first day after arthroscopy compared with lidocaine and pethidine alone.