Perioperative Anesthesia: To Do or Not to Do?

Abstract

Introduction. In patients with chronic loco-motor system diseases the pain often persists after arthroplasty and does not respond to symptomatic therapy.Purpose of study: to evaluate the efficacy of perioperative use of Meloxicam in patients after hip arthroplasty. Patients and methods. The follow-up covered 120 patients (mean age 64.4±5.23 years) after hip arthroplasty. In the main group (n=60) Meloxicam was given 7 days prior to and 3 weeks after surgery; after intervention narcotic analgesic was used on the request. In control group (n=60) the patients were only on narcotic analgesic on request after operation. Treatment results were assessed by 100-millimeter visual analog scale (VAS) and D’Aubigné-Postel Score.Results. Seven days before the surgery the pain severity in the main and control groups was comparable: 85±2.3 and 84±2.1, respectively. In 2 days after operation the pain relief was more pronounced in the main group — 69±2.1 mm versus 82±3.4 mm in the control group (p<0.05). In 3 months those indices made up 10±2.1 and 35±12.6 mm (p<0.001), respectively. In the main group the result was assessed as the excellent and good in 22 patients, in the rest of patients as satisfactory by d’Aubigné-Postel Score. In the control group the good result was recorded in 9, satisfactory — in 47 and poor — in 4 cases.Conclusion. Meloxicam may be considered as an effective perioperative analgesic in large joints arthroplasty.

An old friend: 25 years of meloxicam use in Russia.

“…Фирсова и соавт. [71], в которой оценивались результаты пред-и послеоперационного применения оригинального мелоксикама у больных, перенесших тотальное эндопротезирование тазобедренного сустава. Мелоксикам назначался за три дня до операции перорально в дозе 15 мг, а затем, после хирургического вмешательства, -на 3 недели (первые 3 дня -в/м, затем перорально).…”