Effect of oral and i.v. tenoxicam in postoperative pain after total knee replacement

We have evaluated the effect of oral and i.v. tenoxicam on postoperative pa in after unilateral total knee replacement in a double-blind, randomized, c ontrolled study. Tenoxicam was administered to two groups of patients, eith er before (40 mg orally) or after (40 mg i.v.) surgery, then at 24 h after surgery (40 mg i.v.) and at the end of each day for 8 days (20 mg orally). A third group were given placebo at all times. Ail patients had access to P CA morphine for the first 48 h and then co-dydramol tablets for the duratio n of the study. We studied 101 patients, mean age 67 yr. There was no signi ficant reduction in the requirement for PCA morphine for the duration of th e study in either of the treatment groups, or for co-dydramol in the first 2 days, but tenoxicam significantly reduced the need for co-dydramol over t he remaining 7 days. There were no significant differences in mobility betw een groups. There was a high incidence of adverse events reported, with a s imilar number in each of the three groups.