mobic and Pain--Postoperative

To review data for bupivacaine/meloxicam extended-release (ER) solution for management of postoperative pain and opioid-sparing effects.. Literature search of PubMed (1946 to August 2021) and ProQuest (1946 to August 2021) was performed using the terms: Zynrelef, HTX-011, and "bupivacaine AND meloxicam." Additional information sources include ClinicalTrials.gov, prescribing information, Heron Therapeutics' Clinical and Economic Evidence Dossier, meeting abstracts, and references of identified articles.. Clinical trials and articles evaluating bupivacaine/meloxicam ER for postoperative pain management.. Bupivacaine is a short-acting local anesthetic. Its efficacy is negatively impacted by the acidic environment of surgical sites. Meloxicam, a nonsteroidal antiinflammatory, reduces inflammation at the surgical site and increases pH propagating bupivacaine movement into the neurons. In Phase 2 and Phase 3 clinical trials, bupivacaine/meloxicam ER was compared with bupivacaine HCl, bupivacaine ER, and meloxicam ER with and without scheduled nonopioid multimodal analgesia (MMA) in bunionectomies, herniorrhaphies, total knee arthroplasty and abdominoplasty. Postoperative pain was well controlled for 72 hours and consistently superior to placebo, with minimal or no opioid use. Wound healing was not impacted and adverse effects were similar to placebo (most commonly nausea, dizziness, constipation, and headaches).. Bupivacaine/meloxicam ER is a viable, safe, nonopioid local anesthetic for sustained 72-hour postoperative pain management mitigating opioid consumption.. Bupivacaine/meloxicam ER is the only dual-acting, extended-release local anesthetic available. It provides effective analgesia in the postoperative setting and successfully reduces or eliminates postoperative opioid consumption.

Topics: Analgesics, Opioid; Anesthetics, Local; Bupivacaine; Humans; Meloxicam; Pain, Postoperative

Post-orthopaedic operative pain is a serious concern that often requires the administration of analgesics; however, the optimal time of analgesic administration is still inconclusive. Perioperative analgesia is administrating pre-emptive analgesia before and during the surgery followed by postoperative analgesia to decrease the procedure associated nociceptive response. We aim to assess perioperative meloxicam versus postoperative meloxicam for pain control after orthopaedic operations.. A systematic review and meta-analysis involving randomized controlled trials from PubMed, Embase, Scopus, WOS, and Cochrane until 28th May 2022. We pooled dichotomous outcomes using risk ratio (RR) presented with a 95% confidence interval (CI) and continuous outcomes using mean difference (MD) with 95% CI. We registered our protocol in PROSPERO with ID: CRD42022336046.. Short-term pain management after orthopaedic procedures is better accomplished with perioperative meloxicam than postoperative meloxicam. Before recommending perioperative meloxicam for pain control following orthopaedic surgeries, further multicentre trials are still warranted to examine the impact of perioperative meloxicam in different orthopaedic procedures.

Topics: Analgesia, Patient-Controlled; Analgesics; Humans; Meloxicam; Orthopedic Procedures; Orthopedics; Pain Management; Pain, Postoperative; Randomized Controlled Trials as Topic

This study assesses the budget impact and cost-effectiveness of intravenous meloxicam (MIV) to treat moderate-severe acute postoperative pain in adults.. A two-part Markov cohort model captured the pharmacoeconomic impact of MIV versus non-opioid intravenous analgesics (acetaminophen, ibuprofen, ketorolac) among a hypothetical adult cohort undergoing selected inpatient procedures and experiencing moderate-severe acute postoperative pain: Part 1 (postoperative hour 0 to discharge, cycled hourly), health states were defined by pain level. Pain transition rates, adverse event probabilities, and concomitant opioid utilization were derived from a network meta-analysis. Part 2 (discharge to week 52, cycled weekly), health states were defined by the presence/absence of pain-related readmission and opioid use disorder as determined by literature-based inputs relating to pain control outcomes. Healthcare utilization and direct medical costs were derived from an administrative claims database analysis. Primary outcomes were the incremental cost per member per month (PMPM) and cost per quality-adjusted life year (QALY) gained. Scenario, univariate, and probabilistic sensitivity analyses were conducted. The model assumed a private payer perspective in the USA (no discounting, 2019 US$).. Modeled outcomes indicated MIV was associated with lower accumulated postoperative pain, fewer adverse events, and less opioid utilization for most procedures and comparators, with longer-term outcomes also generally favoring MIV. The budget impact of MIV was - $0.028 PMPM. From a cost-effectiveness perspective, MIV had lower costs and better outcomes for all comparisons except against ketorolac in orthopedic procedures where the former was cost-effective but not cost saving ($95,925/QALY). Scenario and sensitivity analyses indicated that modeled outcomes were robust to alternative inputs and underlying input uncertainty. Differences in direct medical costs were driven by reduced costs attributable to length of stay and opioid-related adverse drug events.. MIV was associated with modeled clinical and economic benefits compared to commonly used non-opioid intravenous analgesics.

Topics: Adult; Analgesics, Opioid; Cost-Benefit Analysis; Humans; Ketorolac; Meloxicam; Pain, Postoperative

Pain following most surgical procedures is expected. However, the treatment and management of postoperative surgical pain have remained challenging. The use of opioid therapy has become increasingly controversial given the limited therapeutic window of these drugs, the adverse side effects, and the potential for abuse. A multimodal approach to the treatment of postoperative pain has been shown to improve pain outcomes after surgery and improve patient satisfaction. Here, we examine a new formulation of bupivacaine and meloxicam extended-release solution HTX-011 (ZYNRELEF®) and its efficacy in postoperative pain control.. HTX-011 exists as an extended-release polymer that controls the release of the active ingredients over 72 hours. A systematic approach was taken to review PubMed (Medline) for prospective and retrospective studies related to the use of HTX-011 for the management of postoperative pain.. HTX-011 represents a new tool to help modulate postoperative pain. Although multimodal analgesia has been effective in managing postoperative pain, direct surgical infiltration with local anesthetics has had limited efficacy due to their short duration of action. The HTX-011 formulation provides a long-acting local anesthetic at the surgical site, which provides a longer period of analgesia while maintaining a favorable safety profile.

Topics: Analgesics, Opioid; Anesthetics, Local; Bupivacaine; Humans; Meloxicam; Pain, Postoperative; Prospective Studies; Retrospective Studies

HTX-011 is an extended-release, dual-acting local anesthetic consisting of bupivacaine (sodium-channel blocker) and low-dose meloxicam (non-steroidal anti-inflammatory drug [NSAID]) applied needle-free during surgery. Introducing low-dose meloxicam addresses the limited efficacy of liposomal bupivacaine in acidic inflamed tissues and allows enhanced analgesic effects over three days. It has great promise to be an extremely effective postoperative pain regimen and produce an opioid-free surgical recovery, as it has consistently significantly reduced pain scores and opioid consumption through 72 h. This manuscript provides an updated, concise narrative review of the pharmacology, clinical efficacy, safety and tolerability of this drug and its applications to prevent postoperative pain.. Lay abstract HTX-011 is a local anesthetic (a drug to induce temporary loss of sensation or awareness, usually during a medical procedure), which is made up of a combination of two drugs and applied needle-free during surgery. It has great promise to provide effective treatment for postoperative pain (pain after an operation), allowing patients to have an opioid-free option for their pain relief. This paper reviews how this drug works and the clinical trials that have taken place so far to investigate its safety and effectiveness in reducing pain after an operation.

Topics: Analgesics, Opioid; Anesthetics, Local; Bupivacaine; Humans; Meloxicam; Pain, Postoperative

Topics: Analgesics, Opioid; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Bupivacaine; Delayed-Action Preparations; Drug Combinations; Drug Interactions; Humans; Meloxicam; Pain, Postoperative

Acute postoperative pain reduction is a major target against the opioid crisis. While opioids have traditionally been the mainstay for postoperative analgesia, current practice has focused on a multimodal approach to pain control, including ultrasound-guided blocks with longer acting local anesthetic agents.. Non-steroidal anti-inflammatory drugs (NSAIDs), such as meloxicam, are an important class of medications utilized to manage pain in the perioperative period. An additional treatment used in perioperative or postoperative pain relief is Exparel, a bupivacaine (sodium channel blocker) liposomal injectable suspension with a 3-4-day duration of action. The long-acting mechanism and formulation of Exparel consistently has demonstrated decreased opioid use and pain scores in patients undergoing many different surgical procedures. A concern is that pH negatively alters the efficacy of bupivacaine, as in cases of inflamed tissue and acidic fluid pH. For this reason, a combination medication with both meloxicam and bupivacaine has been developed, which normalizes pH and has anti-inflammatory and anti-pain conduction properties. Clinical studies demonstrate that this combination agent can be extremely beneficial in treating postoperative pain. This manuscript summarizes the newest developments with regard to liposomal bupivacaine and the non-steroidal meloxicam, their roles in effective treatment of postoperative pain, contraindications, special considerations of using these medications, and future considerations. HTX-011 pairs up a new extended-release formulation of the local anesthetic bupivacaine with meloxicam, a well-established non-steroidal anti-inflammatory drug (NSAID).

Topics: Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Bupivacaine; Delayed-Action Preparations; Drug Therapy, Combination; Humans; Liposomes; Meloxicam; Pain Management; Pain, Postoperative

Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) used mainly in treating pain associated with arthritis. The usual oral dose for osteoarthritis is 15 mg daily, but lower doses of 7.5 mg are advised in older patients. This review sought to evaluate the efficacy and safety of oral meloxicam in acute postoperative pain, using clinical studies of patients with established pain, and with outcomes measured primarily over 6 hours using standard methods. This type of study has been used for many decades to establish that drugs have analgesic properties.. To assess the efficacy of single dose oral meloxicam in acute postoperative pain, and any associated adverse events.. We searched Cochrane CENTRAL (Issue 2, 2009), MEDLINE (June 2009); EMBASE (June 2009); the Oxford Pain Relief Database.. Randomised, double-blind, placebo-controlled clinical trials of oral meloxicam for relief of acute postoperative pain in adults.. Two review authors independently assessed trial quality and extracted data. We planned to use area under the "pain relief versus time" curve to derive the proportion of participants with meloxicam experiencing least 50% pain relief over 4 to 6 hours, using validated equations; to use number needed to treat to benefit (NNT); the proportion of participants using rescue analgesia over a specified time period; time to use of rescue analgesia; information on adverse events and withdrawals.. No studies were identified by the searches that examined oral meloxicam in patients with established postoperative pain.. In the absence of evidence of efficacy, at present, for oral meloxicam in acute postoperative pain, its use in this indication is not justified. Because trials clearly demonstrating analgesic efficacy in the most basic of acute pain studies is lacking, use in other indications should be evaluated carefully. Given the large number of available drugs of this and similar classes, there is no urgent research agenda.

Topics: Acute Disease; Administration, Oral; Adult; Analgesics; Cyclooxygenase Inhibitors; Humans; Meloxicam; Pain, Postoperative; Thiazines; Thiazoles

Total knee arthroplasty (TKA) can be associated with significant postoperative pain despite multimodal analgesic (MMA) protocols, and most patients require the use of opioids postoperatively. HTX-011 is a dual-acting local anesthetic containing bupivacaine and low-dose meloxicam in an extended-release polymer. In a prior randomized controlled trial (RCT), HTX-011 reduced pain and opioid use through 72 hours after TKA compared with bupivacaine hydrochloride. This open-label study (NCT03974932) evaluated the efficacy and safety of HTX-011 combined with an MMA regimen in patients undergoing TKA under spinal anesthesia. All patients received intraoperative HTX-011 (400 mg bupivacaine/12 mg meloxicam) in combination with an MMA regimen consisting of preoperative acetaminophen, celecoxib, and pregabalin and postoperative acetaminophen and celecoxib until discharge. Opioid rescue was allowed upon patient request for additional pain control. Pain scores, opioid consumption, discharge readiness, and adverse events were recorded. Fifty-one patients were treated. Compared with the prior RCT, HTX-011 with this MMA regimen further lowered pain scores and reduced opioid use. Mean patient-reported pain scores remained in the mild range, and 82% of patients or more did not experience severe pain at any individual time point through 72 hours after surgery. Mean total opioid consumption was low over 72 hours: 24.8 morphine milligram equivalents (1-2 tablets of oxycodone 10 mg/day). Approximately 60% of patients were ready for discharge by 12 hours, and 39% were discharged without an opioid prescription and did not call back for pain management. The treatment regimen was well tolerated, and no added risk was observed with the addition of MMA. HTX-011 with an MMA regimen reduced postoperative pain and opioid use following TKA.

Topics: Acetaminophen; Analgesics; Analgesics, Opioid; Anesthetics, Local; Arthroplasty, Replacement, Knee; Bupivacaine; Celecoxib; Humans; Meloxicam; Opioid-Related Disorders; Pain, Postoperative

This study compared an opioid-free injectable anaesthetic protocol with or without multimodal analgesia in kittens undergoing ovariohysterectomy.. In this prospective, randomised, blinded, clinical trial, 29 healthy kittens (mean ± SD weight 1.55 ± 0.46 kg; aged 10 weeks to 6 months) were included. Anaesthesia was performed with an intramuscular injection of ketamine (4 mg/kg), dexmedetomidine (40 μg/kg) and midazolam (0.25 mg/kg). In the multimodal group (MMG), cats (n = 14) received meloxicam (0.1 mg/kg SC) and intraperitoneal bupivacaine 0.25% (2 mg/kg), whereas the same volume of saline was administered in the control group (CG; n = 15). Atipamezole (0.4 mg/kg IM) was given 15 mins after ovariohysterectomy. Postoperative pain was assessed using the UNESP-Botucatu multidimensional feline pain assessment scale - short form. Rescue analgesia (buprenorphine 0.02 mg/kg IM in MMG/CG and meloxicam 0.1 mg/kg SC in CG) was administered if pain scores were ⩾4/12. Soft food intake (after 2 and 60 mins) was evaluated at specific time points postoperatively. Statistical analyses were performed with linear models and post-hoc pairwise comparison with Benjamini-Hochberg corrections (. The prevalence of rescue analgesia was higher in the CG (n = 15/15) than the MMG (n = 1/14;. This opioid-free protocol using multimodal analgesia produced adequate postoperative pain relief, while almost eliminating the need for rescue analgesia in kittens undergoing ovariohysterectomy. Pain decreased food intake.

Topics: Analgesics, Opioid; Anesthesia; Animals; Bupivacaine; Cats; Dexmedetomidine; Eating; Female; Hysterectomy; Injections, Intramuscular; Ketamine; Meloxicam; Midazolam; Ovariectomy; Pain Measurement; Pain, Postoperative; Single-Blind Method

Injectable non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to queens undergoing ovariohysterectomy (OVH), but the requirement for postoperative administration is unclear and practices vary. Existing studies assessing efficacy rely on pain scoring by experienced clinicians. However, following OVH, most cats are discharged within hours of recovery.. Cats undergoing OVH were randomly assigned to two treatment groups: MEL and ROB. Cats in the MEL group (n = 76) received meloxicam (0.2 mg/kg) and those in the ROB group (n = 65) received robenacoxib (2 mg/kg). Owners were contacted by a blinded assessor 3 days postoperatively and asked to identify physical or behavioural changes and to assign pain scores using a numerical rating scale.. More cats in the ROB group displayed abnormal behaviours than cats in the MEL group (p = 0.03). Most owners assigned a pain score of 0 (72%) (n = 101), but pain scores were significantly higher in the ROB group than in the MEL group (p = 0.005).. Methods of owner assessment of pain in cats have not been validated.. Both meloxicam and robenacoxib are effective in controlling postoperative pain. Meloxicam may have improved efficacy in certain patient populations. Applying a blanket approach to prescribing NSAIDs to cats undergoing OVH postoperatively may not be necessary. This has safety, environmental and cost implications.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Cat Diseases; Cats; Female; Hysterectomy; Meloxicam; Ovariectomy; Pain Measurement; Pain, Postoperative; Prospective Studies

Extended-release (ER) local anesthetics can be used in multi-modal analgesia or in situations in which systemic analgesics may alter animal physiology and thus introduce interpretational confounds. In this study, we compared the analgesic efficacy of an ER buprenorphine formulation with that of a synergistic combination of ER bupivacaine and meloxicam. Female and male CD1 mice were randomly assigned to receive subcutaneous buprenorphine (3.25mg/kg) preemptively, subcutaneous infiltration of bupivacaine???meloxicam (0.03mL at incision closure (bupivacaine, 35mg/kg; meloxicam, 1mg/kg), or saline (10mL/kg SC) after induction of anesthesia. After laparotomy, mice were assessed for changes in daily body weight, rearing frequency, nest consolidation scores, time-to-integrate-nest test (TINT), and response to von Frey testing at 4, 8, 24, 48, and 72h after surgery. Daily weight, nest consolidation scores and rearing frequency were not significantly different among the 3 groups. TINT had fallen significantly response at 24 and 48h after injection in the ER buprenorphine group as compared with the saline and ER bupivacaine-meloxicam groups. Nociceptive thresholds, as assessed with von Frey testing, differed between saline controls and both analgesic groups at 4, 8, 24, 48, and 72 h after surgery. None of the mice in the bupivacaine???meloxicam group developed signs of neurotoxicity, a potential side effect of high-dose local anesthetics. This study demonstrates that local ER bupivacaine???meloxicam may be a useful alternative to systemic, ER buprenorphine for the relief of pain after laparotomy in mice.

Topics: Analgesics; Analgesics, Opioid; Anesthetics, Local; Animals; Bupivacaine; Buprenorphine; Female; Laparotomy; Male; Meloxicam; Mice; Pain; Pain, Postoperative; Rodent Diseases

QP001, a novel meloxicam formulation, has been developed to manage moderate to severe postoperative pain. This study aimed to evaluate the efficacy and safety of QP001 injections for moderate to severe pain following abdominal surgery.. This prospective, multicenter, randomized, double-blind, placebo-controlled clinical trial enlisted patients experiencing moderate to severe pain following abdominal surgery. These patients were randomized to receive either QP001 injections (30 mg or 60 mg) or a placebo pre-surgery. The primary efficacy endpoint was the total morphine consumption within 24 h after the first administration.. A total of 108 patients were enrolled, and 106 patients completed the study. The total morphine consumption in the QP001 30 mg group and 60 mg group, versus placebo group, were significantly lower over the following 24 h (5.11[5.46] vs 8.86[7.67], P = 0.011; 3.11[3.08] vs 8.86[7.67], P < 0.001), respectively. The total morphine consumption in the QP001 30 mg and 60 mg groups, versus placebo group, was also significantly decreased over the following 48 h, including the 24-48 h period (P ≤ 0.001). The QP001 30 mg and 60 mg groups, versus placebo, showed a significant decrease in the area under the curve for pain intensity-time as well as a significant decrease in the effective pressing times of the analgesic pump over the 24 h and 48 h periods (P < 0.05). The QP001 groups, versus placebo, show no significant different in Adverse Events or Adverse Drug Reactions (P > 0.05).. Preoperative/preemptive QP001 provides analgesia and reduces opioid consumption in patients with moderate to severe pain following abdominal surgery, while maintaining a favorable safety profile.

Topics: Analgesia; Analgesics, Opioid; Humans; Meloxicam; Morphine; Pain, Postoperative; Prospective Studies

Acupuncture has the same analgesic effect as non-steroidal antiinflammatory drugs and opioids. It is challenging to perform preoperative acupuncture in unmanageable animals, while the residual postoperative anesthetic effect facilitates the performance of acupuncture postoperatively.. To compare preoperative acupuncture or meloxicam versus postoperative acupuncture for postoperative analgesia after ovariohysterectomy.. This is a horizontal prospective positive control blind randomized experimental study. Thirty-six dogs were randomly divided into three groups: GA (preemptive acupuncture), GPA (postoperative acupuncture), and GM (meloxicam 0.2 mg/kg IV preoperatively). After sedation with acepromazine (0.05 mg/kg IM), anesthesia was induced with propofol (5.3 ± 0.3 mg/kg) and maintained with isoflurane/O2. Fentanyl (2 μg/kg, IV) was administered immediately before surgery. Bilateral acupuncture was performed at acupoints Large intestine 4, Spleen 6, and Stomach 36 for 20 minutes, before (GA) or immediately after surgery (GPA). Pain was evaluated by an observer blind to the treatment using the Glasgow scale before and for 24 hours after ovariohysterectomy. Dogs with a score ≥ 6 received rescue analgesia with morphine (0.5 mg/kg IM). Nonparametric data were analyzed by the Kruskal-Wallis test, followed by Dunn's test and parametric data by ANOVA followed by Tukey's test.. Two GA and one GPA dogs received rescue analgesia once. Two GM dogs received rescue analgesia and one of those was treated again twice. There were no differences in the number of dogs receiving rescue analgesia between groups (p = 0.80).. Postoperative acupuncture was as effective as preoperative acupuncture or meloxicam in female dogs undergoing ovariohysterectomy.

Topics: Acupuncture Therapy; Animals; Dogs; Female; Hysterectomy; Meloxicam; Ovariectomy; Pain, Postoperative; Prospective Studies

Post-operative pain and inflammation are normal physiological reactions to caesarean section. Their management in cattle have rarely been investigated. This surgical procedure negatively affects reproductive function with, for example, a reduction in fertility resulting in an increase in calving interval. In this multicenter clinical trial, the objective was to evaluate the impact on reproductive performance of meloxicam injected before caesarean section to manage post-operative pain and inflammation. Meloxicam is a non-steroidal anti-inflammatory drug. One hundred and twenty-seven Charolais heifers (n = 127) were recruited from 47 farms in six French veterinary practices in the Burgundy region. The heifers underwent a non-elective standardized caesarean section operation. Heifers were randomly assigned to one of two groups: meloxicam (n = 66), intravenous meloxicam injection before surgery, or control (n = 61). Reproductive performance and health information were recorded from the time of the caesarean section to the next calving or to culling. In our study, meloxicam administration before caesarean section had no effect on the incidence of retained placenta (18.2% of treated vs 25.0% of control cows, p = 0.35). The pregnancy rate was higher in treated than in control cows (83.1% vs 67.8%, p = 0.04 after multivariate analysis) and a survival analysis showed that the median calving interval was 35 days shorter in the meloxicam (t

Topics: Animals; Cattle; Cattle Diseases; Cesarean Section; Female; Inflammation; Meloxicam; Pain, Postoperative; Pregnancy; Reproduction

To evaluate the cyclooxygenases (COX) inhibition, adverse effects and analgesic efficacy of dipyrone or meloxicam in cats undergoing elective ovariohysterectomy.. Prospective, blinded, randomized, clinical study.. A total of 30 healthy young cats.. The cats were randomly assigned to three postoperative groups: D25 (dipyrone 25 mg kg. In the first half hour after analgesic administration, COX-1 activity was close to zero and remained significantly lower than before drug administration for 24 hours in all groups. The inhibition of COX-2 activity was significant for 30 minutes in all groups and up to 4 hours in group M. No alterations in laboratory tests or significant adverse effects were observed. Pain scores and need for rescue analgesia did not differ statistically among groups.. Dipyrone at both doses and meloxicam provided a nonselective inhibition of COX-1 and -2 activities and effective analgesia without causing significant adverse effects or laboratory tests alterations.. Dipyrone at both doses provides equally effective analgesia without causing adverse effects in cats undergoing ovariohysterectomy.

Topics: Analgesics; Animals; Cat Diseases; Cats; Cyclooxygenase 1; Cyclooxygenase Inhibitors; Dipyrone; Female; Hysterectomy; Meloxicam; Ovariectomy; Pain, Postoperative; Prospective Studies; Prostaglandin-Endoperoxide Synthases

Meloxicam for intravenous use (meloxicam iv.) is a nanocrystal formulation with improved dissolution properties and shortened time to peak plasma concentrations versus oral meloxicam. In Phase III and IIIb trials, 30 mg once daily relieved pain following pre- or postoperative administration in orthopedic, abdominal and colorectal surgeries. Meloxicam iv. was associated with reduced opioid consumption, the clinical benefit of which remains unclear. The drug may be administered alone or in combination with other non-nonsteroidal anti-inflammatory drugs. In Phase III trials, it demonstrated adverse event profile similar to placebo, with nausea, constipation, vomiting and headache occurring most frequently. Meloxicam iv. does not appear to adversely affect platelet function or wound-healing parameters. No new safety signals were detected in the Phase IIIb studies.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Humans; Meloxicam; Pain Measurement; Pain, Postoperative; Treatment Outcome

To evaluate the effect of perioperative meloxicam IV 30 mg on opioid consumption in primary total knee arthroplasty (TKA).. Multicenter, randomized, double-blind, placebo-controlled trial.. In total, 181 adults undergoing elective primary TKA.. Subjects received meloxicam 30 mg or placebo via an IV bolus every 24 hours, the first dose administered prior to surgery as part of a multimodal pain management protocol. The primary efficacy parameter was total opioid use from end of surgery through 24 hours.. Meloxicam IV was associated with less opioid use versus placebo during the 24 hours after surgery (18.9 ± 1.32 vs 27.7 ± 1.37 mg IV morphine equivalent dose; P < 0.001) and was superior to placebo on secondary endpoints, including summed pain intensity (first dose to 24 hours postdosing, first dose to first assisted ambulation, and first dose to discharge) and opioid use (48-72 hrs., 0-48 hrs., 0-72 hrs., hour 0 to end of treatment, and the first 24 hours after discharge). Adverse events (AEs) were reported for 69.9% and 92.0% of the meloxicam IV and placebo groups, respectively; the most common AEs were nausea (40% vs. 59%), vomiting (16% vs 22%), hypotension (14% vs 15%), pruritus (15% vs 11%), and constipation (11% vs 13%).. Perioperative meloxicam IV 30 mg as part of a multimodal analgesic regimen for elective primary TKA reduced opioid consumption in the 24-hour period after surgery versus placebo and was associated with a lower incidence of AEs typically associated with opioid use.

Topics: Adult; Analgesics, Opioid; Arthroplasty, Replacement, Knee; Double-Blind Method; Humans; Meloxicam; Pain Management; Pain Measurement; Pain, Postoperative

This study compared bupivacaine (BUP), bupivacaine-lidocaine-epinephrine (BLE), dexamethasone (DEX), and meloxicam (MEL) targeted at specific, potentially painful sites for reducing acute postoperative pain in cats undergoing elective ovariohysterectomy. One hundred fifty-one cats were included in a prospective, randomized, double-blinded clinical trial. Anesthesia consisted of a standardized protocol including buprenorphine, ketamine, dexmedetomidine, and isoflurane. A ventral midline ovariohysterectomy was performed, and cats were administered targeted injections of 0.5% bupivacaine (2 mg/kg); a combined 0.25% bupivacaine (1 mg/kg), 1% lidocaine (2 mg/kg), and 1:100,000 epinephrine (0.005 mg/kg); dexamethasone (0.125 mg/kg); or meloxicam (0.2 mg/kg) intraoperatively at the ovarian suspensory ligaments, uterine body, and incisional subcutaneous tissues. A 0-10 Numeric Pain Rating Scale (NRS) was used to assess cats postoperatively, 1 hour and 3 hours after anesthesia recovery prior to a same day discharge. Pain scores among evaluators were in good agreement with an overall Intraclass Correlation Coefficient (ICC) of 0.7897 (95% Confidence Interval 0.795-0.8313).  In all groups, overall pain scores 1-hour post anesthesia recovery were significantly higher than scores 3 hours post anesthesia recovery (P < .0001). Averaged pain scores compared among treatment groups did not differ at 1 hour post recovery. At 3-hours post anesthesia recovery, MEL group cats had significantly lower pain scores than the BLE group (P = .018). Study results indicate that early postoperative pain scores were similar for cats receiving local infiltrations of BUP, BLE, DEX, and MEL as part of a multimodal pain therapy for routine ovariohysterectomies. MEL showed somewhat better results 3 hours post anesthesia recovery, gaining significance over the BLE group.

Topics: Animals; Bupivacaine; Cat Diseases; Cats; Dexamethasone; Epinephrine; Lidocaine; Meloxicam; Pain, Postoperative; Prospective Studies

This study aimed to compare the efficacy and safety of pre-operative and post-operative meloxicam administration regarding post-operative pain control and knee joint function recovery in knee osteoarthritis (KOA) patients who underwent total knee arthroplasty (TKA).. Totally, 196 KOA patients who underwent TKA were consecutively enrolled and randomly assigned into pre-operative (N = 98) and post-operative administration group (N = 98) as 1:1 ratio. Pre-operative administration group received meloxicam 15 mg at 24 h pre-operation and 7.5 mg at 4 h, 24 h, 48 h, and 72 h post-operation, respectively. Post-operative administration group received meloxicam 15 mg at 4 h post-operation and 7.5 mg at 24 h, 48 h, and 72 h post-operation, respectively. Pain visual analog scale (VAS) at rest and at flexion, patient's global assessment (PGA), patient-controlled analgesia (PCA) consumption, hospital for special surgery (HSS), knee score, and adverse events were assessed.. Pre-operative meloxicam administration attenuated pain VAS score at rest at 6 h, 12 h, and 24 h; and pain VAS score at flexion at 6 h, 12 h, 24 h, and 48 h; as well as PGA score at 6 h, 12 h, 48 h post-TKA compared with post-operative meloxicam administration. Additional and total consumption of PCA were both decreased in pre-operative meloxicam administration group than post-operative meloxicam administration group, while HSS knee score at 3 months post-TKA was similar between pre-operative and post-operative meloxicam administration groups. Regarding safety, the incidence of adverse events was of no difference between the two groups.. Pre-operative administration of meloxicam might assist the post-operative pain management and care in KOA patients who underwent TKA.

Topics: Aged; Analgesics; Arthroplasty, Replacement, Knee; Female; Humans; Male; Meloxicam; Osteoarthritis, Knee; Pain, Postoperative; Postoperative Period; Preoperative Care; Recovery of Function

There are limited published data on the analgesic efficacy of paracetamol/codeine in dogs.. Prospective, randomised, blinded, positive-controlled clinical trial with 70 dogs (paracetamol/codeine, n=46; meloxicam, n=24) undergoing surgery. Drugs were administered orally 2 hours before and for 48 hours after surgery at the licensed dose. Anaesthesia was standardised. Dogs received buprenorphine 6 hourly for the first 24 hours after surgery. Outcome assessments were made pretrial and at regular intervals up to 48 hours after extubation and comprised the Glasgow Composite Measure Pain Score-Short Form, visual analogue scale for sedation and inflammation and mechanical nociceptive threshold (MNT). Non-inferiority of paracetamol/codeine compared with meloxicam was defined using a non-inferiority margin (Δ) against the 95 per cent confidence interval of the difference between the treatment means.. Pain scores were low in both treatment groups. With the exception of MNT all upper 95 per cent confidence intervals for the differences between outcome variable treatment means were within +Δ for each variable, establishing non-inferiority for each outcome variable.. Paracetamol/codeine is a useful perioperative analgesic that within the context of the perioperative analgesia regimen studied (methadone premedication, buprenorphine for the first 24 hours after surgery) shows non-inferiority to the NSAID meloxicam.

Topics: Acetaminophen; Analgesics; Animals; Codeine; Dogs; Drug Combinations; Female; Male; Meloxicam; Pain, Postoperative; Prospective Studies; Single-Blind Method; Treatment Outcome

To compare the analgesic effect of topical lidocaine-prilocaine (LP) cream and rectal meloxicam suppository on the post-episiotomy pain in primigravidae.. A randomized open-label clinical trial included primigravidae delivered vaginally with episiotomy. Eligible women were recruited and randomized to topical LP cream on the episiotomy line or rectal meloxicam suppository 15 mg. The intensity of the perineal pain was assessed using a visual analog scale (VAS) immediately, at 6, 12 h and after 5 days post-episiotomy.. One hundred ninety women were enrolled (n = 95 in each arm). No difference between both groups in the VAS scores immediately (mean ± SD: 8.54 ± 1.35 vs. 8.33 ± 1.50, p = 0.419) and 6 h after episiotomy (p = 0.859). However, women in the LP arm were more likely to report lower VAS scores at 12 h and 5 days post-episiotomy (mean ± SD: 1.20 ± 0.50 vs. 5.65 ± 1.65, p = 0.0001; 1.19 ± 0.49 vs. 2.64 ± 1.73, p < 0.001; respectively).. Application of topical LP cream after repair of episiotomy in primigravidae seems to substantially alleviate the induced pain with subsequent less need for additional analgesia and more patients' satisfaction.

Topics: Administration, Topical; Adolescent; Adult; Analgesia; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Episiotomy; Female; Gravidity; Humans; Lidocaine; Meloxicam; Pain, Postoperative; Pregnancy; Prilocaine; Suppositories; Young Adult

Magnesium may be used as an adjunctive analgesic for perioperative pain management because of its antinociceptive properties. This study investigated the analgesic efficacy of intraperitoneal ropivacaine combined with magnesium sulfate in canine ovariohysterectomy. Forty-five dogs sedated with acepromazine/meperidine and anesthetized with propofol/isoflurane were randomly distributed into three treatments, administered intraperitoneally (n = 15 per group): saline solution (group S), 0.25% ropivacaine (3 mg/kg) alone (group R), or in combination with magnesium sulfate (20 mg/kg, group R-Mg). Intravenous fentanyl was given to control cardiovascular responses to surgical stimulation. Postoperative pain was assessed using an Interactive Visual Analog Scale (IVAS), the short form of the Glasgow Composite Pain Scale, and mechanical nociceptive thresholds. Morphine/meloxicam was administered as rescue analgesia. Intraoperatively, the R-Mg group required less fentanyl (p = .02) and exhibited higher incidence of hypotension (systolic arterial pressure <90 mm Hg, p = .006) compared with the S group. Lower IVAS pain scores were recorded during the first hour in the R-Mg group than the other groups (p = .007-.045). Postoperative rescue analgesia did not differ between groups. Intraperitoneal magnesium sulfate administration, in spite of decreasing intraoperative opioid requirements, increased the incidence of hypotension with minimal evidence of postoperative analgesic benefits.

Topics: Analgesics; Anesthetics, Local; Animals; Dog Diseases; Dogs; Drug Synergism; Female; Fentanyl; Hysterectomy; Magnesium Sulfate; Meloxicam; Morphine; Ovariectomy; Pain, Postoperative; Perioperative Care; Ropivacaine

Infiltration of the surgical site with local anesthetics combined with nonsteroidal anti-inflammatory drugs may play an important role in improving perioperative pain control. This prospective, randomized, blinded, controlled clinical trial aimed to evaluate intraoperative isoflurane requirements, postoperative analgesia, and adverse events of infiltration of the surgical site with ropivacaine alone and combined with meloxicam in cats undergoing ovariohysterectomy. Forty-five cats premedicated with acepromazine/meperidine and anesthetized with propofol/isoflurane were randomly distributed into three treatments (n = 15 per group): physiological saline (group S), ropivacaine alone (1 mg/kg, group R) or combined with meloxicam (0.2 mg/kg, group RM) infiltrated at the surgical site (incision line, ovarian pedicles and uterus). End-tidal isoflurane concentration (FE'ISO), recorded at specific time points during surgery, was adjusted to inhibit autonomic responses to surgical stimulation. Pain was assessed using an Interactive Visual Analog Scale (IVAS), UNESP-Botucatu Multidimensional Composite Pain Scale (MCPS), and mechanical nociceptive thresholds (MNT) up to 24 h post-extubation. Rescue analgesia was provided with intramuscular morphine (0.1 mg/kg) when MCPS was ≥6.. Area under the curve (AUC) of FE'ISO was significantly lower (P < 0.0001) in the RM (17.8 ± 3.1) compared to S (23.1 ± 2.2) and R groups (22.8 ± 1.1). Hypertension (systolic arterial pressure > 160 mmHg) coinciding with surgical manipulation was observed only in cats treated with S and R (4/15 cats, P = 0.08). The number of cats receiving rescue analgesia (4 cats in the S group and 1 cat in the R and RM groups) did not differ among groups (P = 0.17). The AUC of IVAS, MCPS and MNT did not differ among groups (P = 0.56, 0.64, and 0.18, respectively). Significantly lower IVAS pain scores were recorded at 1 h in the RM compared to the R and S groups (P = 0.021-0.018). There were no significant adverse effects during the study period.. Local infiltration with RM decreased intraoperative isoflurane requirements and resulted in some evidence of improved analgesia during the early postoperative period. Neither R nor RM infiltration appeared to result in long term analgesia in cats undergoing ovariohysterectomy.

Topics: Anesthetics, Local; Animals; Cats; Female; Hysterectomy; Meloxicam; Ovariectomy; Pain, Postoperative; Perioperative Care; Ropivacaine

This study aimed to compare the analgesic effect, patients' satisfaction, tolerance and hip-joint function recovery by preoperative meloxicam versus postoperative meloxicam in treating hip osteoarthritis (OA) patients receiving total hip arthroplasty (THA). 132 hip OA patients who underwent THA surgery were allocated into postoperative analgesia (POST) and preoperative analgesia (PRE) groups at a 1:1 ratio. In the PRE group, patients took meloxicam 15 mg at 24 h pre-operation, 7.5 mg at 4 h, 24 h, 48 h and 72 h post-operation; in the POST group, patients received meloxicam 15 mg at 4 h post-operation, then 7.5 mg at 24 h, 48 h and 72 h post-operation. Furthermore, postoperative pain, consumption of patient-controlled analgesia (PCA), overall satisfaction and adverse events were evaluated within 96 h post-operation; meanwhile, Harris hip score was assessed within 6 months post-operation. Pain VAS at rest at 6 h, 12 h, 24 h, and pain VAS at passive movement at 6 h, 12 h were decreased in PRE group compared to POST group. In addition, additional consumption of PCA and the total consumption of PCA were both reduced in PRE group compared to POST group. Additionally, overall satisfaction in PRE group was higher at 24 h, 48 h and 72 h compared to POST group. While Harris hip score was of no difference between POST group and PRE group at M3 or M6. Besides, no difference in adverse events incidence was found between the two groups. In conclusion, preoperative meloxicam achieves better efficacy and similar tolerance compared to postoperative meloxicam in hip OA patients post THA.

Topics: Arthroplasty, Replacement, Hip; Female; Humans; Male; Meloxicam; Middle Aged; Osteoarthritis, Hip; Pain; Pain Management; Pain Measurement; Pain, Postoperative; Patient Satisfaction; Recovery of Function

Currently available local anesthetics have not demonstrated sufficient analgesia beyond 12-24 h postoperatively. The purpose of the study was to assess the safety and efficacy of HTX-011 (bupivacaine and meloxicam in Biochronomer. A phase 3, randomized, double-blind, active-controlled multi-center study (EPOCH 2; NCT03237481) in subjects undergoing unilateral open inguinal herniorrhaphy with mesh placement was performed. Subjects randomly received a single intraoperative dose of HTX-011, immediate-release bupivacaine HCl, or saline placebo prior to closure.. The study evaluated 418 subjects, and the primary and all key secondary efficacy endpoints were in favor of HTX-011. HTX-011 reduced mean pain intensity by 23% versus placebo (primary endpoint; p < 0.001) and by 21% versus bupivacaine HCl (p < 0.001) with significant reductions in the number of patients experiencing severe pain. Opioid consumption over 72 h was reduced by 38% versus placebo (p < 0.001) and 25% versus bupivacaine HCl (p = 0.024). Overall, 51% of HTX-011 subjects were opioid-free through 72 h (versus 22% for placebo [p < 0.001] and 40% for bupivacaine HCl [p = 0.049]). HTX-011 was generally well-tolerated with fewer opioid-related adverse events reported compared to the bupivacaine HCl and placebo and no evidence of local anesthetic systemic toxicity.. HTX-011 demonstrated significant improvement in postoperative pain control and a clinically meaningful reduction in opioid consumption when compared to the most widely used local anesthetic, bupivacaine HCl.

Topics: Adult; Analgesics, Opioid; Anesthetics, Local; Bupivacaine; Double-Blind Method; Female; Hernia, Inguinal; Herniorrhaphy; Humans; Male; Meloxicam; Middle Aged; Pain Management; Pain Measurement; Pain, Postoperative

This study aimed to investigate the efficacy and safety between early preoperative administration and postoperative administration of oral meloxicam in patients underwent arthroscopic knee surgery (AKS).. Totally 296 patients with the intention to undergo AKS were recruited and randomly allocated as 1:1 ratio into early preoperative analgesia (EPA) group and postoperative analgesia (POA) group. Pain visual analog scale (VAS) score and severity (at rest and at flexion), patient global assessment (PGA) score, the consumption of rescue analgesia (pethidine), and adverse events were evaluated during the perioperation. And knee range of motion (ROM), International Knee Documentation Committee (IKDC) score, and Lysholm score were assessed at baseline and at 3 months after AKS.. Both pain VAS score and severity (at rest and at flexion) were decreased at 4, 8, and 12 hours, but similar at -24, -2, 24, 36, and 48 hours after AKS in EPA group compared with POA group. Besides, PGA score was lower at 4, 8, 12, and 24 hours, but similar at -24, -2, 36, and 48 hours after AKS in EPA group compared with POA group. As to the consumption of pethidine in perioperative period, it was decreased in EPA group compared with POA group. No difference was observed in knee ROM, IKDC score, Lysholm score, and adverse effects between EPA group and POA group.. Early preoperative administration of meloxicam was a superior approach in pain control compared with postoperative administration in treating patients underwent AKS.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Arthroscopy; Female; Humans; Knee Joint; Male; Meloxicam; Middle Aged; Pain Management; Pain Measurement; Pain, Postoperative; Postoperative Period; Preoperative Period; Range of Motion, Articular; Recovery of Function; Time Factors

To compare meloxicam and robenacoxib for short-term postoperative pain management after combined laparoscopic ovariectomy and laparoscopic-assisted gastropexy.. Double-blind, prospective, randomised clinical trial.. Twenty-six client-owned female dogs.. Dogs undergoing combined laparoscopic ovariectomy and laparoscopic-assisted gastropexy were randomly divided into 2 groups. Before induction of anesthesia, 13 dogs received meloxicam (0.2 mg/kg subcutaneously), and 13 dogs received robenacoxib (2 mg/kg subcutaneously). Pain was scored with the Glasgow Composite Pain Scale (short form) before surgery and at 1, 6, 12, 18, and 24 hours after extubation. Rescue analgesia (tramadol, 3 mg/kg) was provided to dogs with a Glasgow pain score (GPS) ≥5. Glasgow pain scores were analyzed by ANOVA with treatment, age, and surgical time as fixed factors.. Glasgow pain scores were higher at 24 hours postsurgery in dogs treated with robenacoxib (2.18 ± 0.29) compared with those treated with meloxicam (0.68 ± 0.41, P = .04). Two dogs treated with meloxicam and 7 dogs treated with robenacoxib required rescue analgesia. Regardless of the treatment, the overall GPS was lower at 18 and 24 hours postsurgery when the surgical time was >40 minutes compared with surgical times ≤40 minutes, but surgical site inflammation was likely a confounding factor in this finding. Glasgow pain score was not affected by patient age.. Meloxicam was more effective than robenacoxib at controlling pain in the population of dogs reported here.. Preoperative administration of meloxicam effectively controls pain for 24 hours after combined laparoscopic ovariectomy and laparoscopic-assisted gastropexy, but rescue analgesia may be required.

Topics: Analgesia; Anesthesia; Animals; Anti-Inflammatory Agents, Non-Steroidal; Diphenylamine; Dogs; Double-Blind Method; Female; Gastropexy; Laparoscopy; Meloxicam; Ovariectomy; Pain Management; Pain Measurement; Pain, Postoperative; Phenylacetates; Prospective Studies; Random Allocation

An intravenous (IV) formulation of meloxicam is being studied for moderate to severe pain management. This phase 3, randomized, multicenter, double-blind, placebo-controlled trial evaluated the safety of once-daily meloxicam IV 30 mg in subjects following major elective surgery. Eligible subjects were randomized (3:1) to receive meloxicam IV 30 mg or placebo administered once daily. Safety was evaluated via adverse events, clinical laboratory tests, vital signs, wound healing, and opioid consumption. The incidence of adverse events was similar between meloxicam IV- and placebo-treated subjects (63.0% versus 65.0%). Investigators assessed most adverse events as mild or moderate in intensity and unrelated to treatment. Adverse events of interest (injection-site reactions, bleeding, cardiovascular, hepatic, renal, thrombotic, and wound-healing events) were similar between groups. Over the treatment period, meloxicam IV was associated with a 23.6% (P = .0531) reduction in total opioid use (9.2 mg morphine equivalent) compared to placebo-treated subjects. The results suggest that meloxicam IV had a safety profile similar to that of placebo with respect to numbers and frequencies of adverse events and reduced opioid consumption in subjects with moderate to severe postoperative pain following major elective surgery.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Drug-Related Side Effects and Adverse Reactions; Elective Surgical Procedures; Female; Humans; Injections, Intravenous; Male; Meloxicam; Middle Aged; Pain Management; Pain Measurement; Pain, Postoperative; Young Adult

An intravenous (IV) formulation of meloxicam was developed for moderate-to-severe pain management. This study evaluated the safety and efficacy of meloxicam IV after open abdominal hysterectomy. Meloxicam IV is an investigational product not yet approved by the US Food and Drug Administration.. Women (N = 486) with moderate-to-severe pain after open abdominal hysterectomy were enrolled in this multicenter, randomized, double-blind, placebo- and active-controlled trial. Subjects were randomized to receive a single dose of meloxicam IV (5-60 mg), placebo, or morphine (0.15 mg/kg) in ≤6 hours after morphine dosing on postoperative day 1 and were evaluated for 24 hours. Rescue morphine (≈0.15 mg/kg IV) was available if needed for pain not relieved by the study medication. In an open-label extension (N = 295), meloxicam IV was administered once daily for the remaining hospital stay (or per the investigator's discretion). The coprimary efficacy end points were the summed pain intensity difference (SPID24) and total pain relief (TOTPAR24) from hour 0 to 24 hours after dosing. Effect size, the standardized difference between means reported in standard deviation (SD) units, was calculated to indicate the magnitude of the difference in the mean analgesic effect measured for different intervention groups.. Subjects who received morphine or meloxicam IV had a median time to first perceptible pain relief within 6-8 minutes. Morphine and meloxicam IV 5-60 mg produced statistically significant differences than placebo in SPID24 and TOTPAR24. SPID24 (standard error [SE]) for meloxicam IV 5-60 mg ranged from -56276.8 (3926.46) to -33517.1 (3930.1; P < .001); SPID24 (SE) for morphine and placebo were -29615.8 (3869.2; P < .001) and 4555.9 (3807.1), respectively. SPID24 effect sizes (95% confidence intervals) for the 60, 30, 15, 7.5, and 5 mg meloxicam IV doses and morphine were 1.93 (1.61-2.25), 2.00 (1.65-2.35), 1.70 (1.35-2.05), 1.28 (0.95-1.60), 1.25 (0.90-1.61), and 1.12 (0.77-1.45) SDs, respectively. TOTPAR24 (SE) for meloxicam IV 5-60 mg ranged from 3104.5 (155.28) to 4130.4 (191.17; P < .001); TOTPAR24 (SE) for morphine and placebo were 2723.3 (188.4; P < .001) and 1100.6 (185.4), respectively. TOTPAR24 effect sizes (95% confidence interval) for the 60, 30, 15, 7.5, and 5 mg meloxicam IV doses and morphine were 2.03 (1.70-2.35), 2.05 (1.70-2.40), 1.78 (1.43-2.13), 1.35 (1.03-1.67), 1.37 (1.01-1.72), and 1.10 (0.75-1.45) SDs, respectively. The mean total opioid consumed (SD) during the double-blind phase was 4.6 (8.17), 5.3 (8.85), 5.9 (7.85), 8.5 (9.67), 9.3 (9.47), 9.6 (8.12), and 16.0 (10.15) mg for patients in the 60, 30, 15, 7.5, and 5 mg meloxicam IV, morphine, and placebo groups, respectively. Generally, meloxicam IV was well tolerated, evidenced by the incidence of adverse events compared to placebo and lack of deaths and treatment-related serious adverse events.. A meloxicam IV dose of 5-60 mg was generally well tolerated and appeared to reduce opioid consumption in subjects with moderate-to-severe pain after open abdominal hysterectomy. Once-daily administration of meloxicam IV produced analgesic effect within 6-8 minutes postdose that was maintained over a 24-hour dosing interval.

Topics: Adolescent; Adult; Aged; Analgesics; Analgesics, Opioid; Double-Blind Method; Female; Humans; Hysterectomy; Infusions, Intravenous; Meloxicam; Middle Aged; Morphine; Pain Management; Pain Measurement; Pain, Postoperative; Reproducibility of Results; Young Adult

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.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Arthroscopy; Female; Humans; Knee Joint; Male; Meloxicam; Meperidine; Pain Measurement; Pain, Postoperative

Surgical sterilisation to manage free-roaming dog populations is widely used in many countries. However, few studies have examined optimal postoperative pain management regimens at low-resource, high-throughput veterinary clinics. The aim of this study was to examine the efficacy of two intravenous analgesic regimens, preoperative administration of meloxicam and tramadol, or meloxicam alone, in free-roaming dogs undergoing sterilisation. A total of 125 dogs were included, with 64 dogs in the meloxicam-tramadol arm and 61 dogs in the meloxicam-only arm in a non-inferiority study design. Pain levels in sterilisation surgery patients were assessed at four time points after surgery using the Colorado State University Canine Acute Pain Scale, a Visual Analogue Scale and a modified version of the Glasgow Composite Measure Pain Scale - Short Form. Non-inferiority was supported for each of the main scoring outcomes using non-inferiority margins of 0.5, 5 and 0.8, respectively. One dog from the meloxicam-tramadol group and four dogs in the meloxicam-only arm required rescue analgesia, with no difference between groups (P=0.21).The study demonstrated that meloxicam was effective in controlling postoperative pain in a high proportion of dogs. The addition of tramadol alongside meloxicam treatment was not found to be of clinical benefit.

Topics: Analgesics; Animals; Castration; Dogs; Female; Male; Meloxicam; Pain, Postoperative; Perioperative Care; Prospective Studies; Tramadol

This randomized, controlled phase 2 study was conducted to evaluate the analgesic efficacy, safety, and tolerability of single intravenous (IV) doses of 15 mg, 30 mg, and 60 mg meloxicam compared with oral ibuprofen 400 mg and placebo after dental impaction surgery. The primary efficacy end point was the sum of time-weighted pain intensity differences for 0-24 hours postdose. Among 230 evaluable subjects, meloxicam IV 60 mg produced the greatest reduction in pain, followed by the 30-mg and 15-mg doses. Statistically significant differences in summed pain intensity differences over 24 hours were demonstrated for each active-treatment group vs placebo (favoring active treatment) and for meloxicam IV 30 mg and 60 mg vs ibuprofen 400 mg (favoring meloxicam IV). Moreover, there was a statistically significant dose response for meloxicam IV 15 mg to 60 mg. The onset of action for meloxicam IV was rapid and sustained; significant differences in pain intensity differences were detected as early as 10 minutes postdose and lasted through the 24-hour postdose period. Subjects in the meloxicam IV groups were more likely than placebo recipients to achieve perceptible and meaningful pain relief and were less likely to use rescue medication. Patient-reported global evaluation showed that meloxicam IV 60 mg had the highest rating. There were no deaths, serious adverse events, or discontinuations due to adverse events. The incidence of subjects with ≥1 treatment-emergent adverse event was greatest in the placebo group, followed by the groups that received ibuprofen, meloxicam IV 15 mg, 30 mg, and 60 mg. Nausea was the most commonly reported treatment-emergent adverse event.. NCT00945763.

Topics: Administration, Intravenous; Adolescent; Adult; Anti-Inflammatory Agents, Non-Steroidal; Dose-Response Relationship, Drug; Double-Blind Method; Female; Humans; Ibuprofen; Male; Meloxicam; Pain Measurement; Pain, Postoperative; Tooth Extraction; Tooth, Impacted; Young Adult

To evaluate the analgesic efficacy and safety of a novel intravenous (IV) formulation of meloxicam (30 mg) in patients with moderate-to-severe pain following a standardized, unilateral bunionectomy with first metatarsal osteotomy and internal fixation.. Patients who met the criteria for moderate-to-severe postoperative pain were randomized to receive bolus injections of meloxicam IV 30 mg (n=100) or placebo (n=101) administered once daily. The primary efficacy endpoint was the Summed Pain Intensity Difference over 48 hours (SPID48). Secondary efficacy endpoints included sum of time-weighted pain intensity differences (SPID) values at other timepoints/intervals, time to first use of rescue analgesia, and number of rescue doses taken. Safety assessments included the incidence of adverse events (AEs), physical examinations, laboratory tests, 12-lead electrocardiography, and wound healing.. Patients randomized to meloxicam IV 30 mg exhibited a statistically significant difference in SPID48 versus the placebo group (P=0.0034). Statistically significant differences favoring meloxicam IV over placebo were also observed for secondary efficacy endpoints, including SPID at other times/intervals (SPID6: P=0.0153; SPID12: P=0.0053; SPID24: P=0.0084; and SPID24-48: P=0.0050) and first use of rescue medication (P=0.0076). Safety findings indicated that meloxicam IV 30 mg was generally well tolerated; no serious AEs or bleeding events were observed. Most AEs were assessed by the investigator to be mild in intensity, and no patients discontinued due to AEs. There were no meaningful differences between the study groups in vital signs, electrocardiographic findings, or laboratory assessments. In most cases, investigators found that wound healing followed a normal course and mean wound-healing satisfaction scores were similar for meloxicam IV 30 mg and placebo.. Meloxicam IV doses of 30 mg provided effective pain relief when administered once daily by bolus injection to patients with moderate-to-severe pain following bunionectomy, and had an acceptable safety profile.

Topics: Administration, Intravenous; Anti-Inflammatory Agents, Non-Steroidal; Bunion; Double-Blind Method; Electrocardiography; Follow-Up Studies; Humans; Internal Fixators; Meloxicam; Middle Aged; Osteotomy; Pain Measurement; Pain, Postoperative; Severity of Illness Index; Treatment Outcome

Managing postoperative pain in rodents is an important part of any animal care and use program, and identifying an optimal analgesic plan for a surgical procedure is critical to providing for animal welfare. Opioids and NSAID are commonly used in rodents, but few studies have evaluated their efficacy in surgical models. The current study aimed to evaluate the therapeutic efficacy of clinically relevant doses of buprenorphine (2 formulations) or meloxicam used in combination with ketamine and xylazine anesthesia in a Sprague-Dawley rat ovariohysterectomy surgical model. Rats received either subcutaneous saline once daily for 3 d, low-dose (0.05 mg/kg SC) or high-dose (0.1 mg/kg SC) buprenorphine twice daily for 3 d, a single injection of sustained-release buprenorphine (1.2 mg/kg SC), or low-dose (1 mg/kg SC) or high-dose (2 mg/kg SC) meloxicam once daily for 3 d. Clinical analgesic efficacy was assessed over 8 d according to cageside observation scoring, body weight, and behavioral testing. Ovariohysterectomy was associated with 2 d of postoperative pain, and all 3 buprenorphine dosing strategies and both doses of meloxicam demonstrated varying amounts of analgesia. Given the results of the current study, we recommend 0.05 mg/kg SC buprenorphine at least twice daily or a single dose of 1.2 mg/kg SC of sustained-release buprenorphine for rats undergoing midline laparotomy with ovariohysterectomy. Alternatively, meloxicam at 1 to 2 mg/kg SC once daily could be used for this indication.

Topics: Analgesia; Analgesics, Opioid; Animals; Anti-Inflammatory Agents, Non-Steroidal; Body Weight; Buprenorphine; Female; Laboratory Animal Science; Laparotomy; Meloxicam; Pain Measurement; Pain, Postoperative; Rats; Rats, Sprague-Dawley

Objectives The aim of this study was to evaluate the analgesic efficacy of intraperitoneal (IP) bupivacaine in cats undergoing ovariohysterectomy (OVH). Methods Forty-five cats were included in a randomized, prospective, blinded study after owners' written consent was obtained. The anesthetic protocol included acepromazine-buprenorphine-propofol-isoflurane. A ventral midline incision was made and cats (n = 15/group) were administered either IP saline 0.9% (negative and positive control groups; NG and PG, respectively) or IP bupivacaine (2 mg/kg; bupivacaine group; BG). Cats in the PG received meloxicam (0.2 mg/kg SC). An OVH was performed and postoperative pain was evaluated using a dynamic interactive visual analog scale (DIVAS), the UNESP-Botucatu multidimensional composite pain scale (MCPS) and mechanical nociceptive thresholds (MNT) for up to 8 h after the end of surgery. Postoperative sedation was evaluated using DIVAS. Rescue analgesia was provided with buprenorphine and/or meloxicam. Repeated measures linear models and a Cochran-Mantel-Haenszel test were used for statistical analysis ( P <0.05). Results There was a significant effect of treatment on the number of times rescue analgesia was administered ( P = 0.002) (PG, n = 2, 13%; NG, n = 12, 80%; BG, n = 4, 27%) with the number of rescues being higher in the NG group than in the PG ( P = 0.0004) and BG ( P = 0.02) groups. The DIVAS, MCPS and MNT were significantly different when compared with baseline values at different time points; however, data were not significantly different among groups. Conclusions and relevance Treatments PG and BG produced similar analgesia in terms of pain scores, number of times rescue analgesia was administered and MNT. Based on rescue analgesia, IP administration of bupivacaine provides analgesia in cats after OVH.

Topics: Analgesics, Opioid; Anesthesia; Anesthetics, Local; Animals; Anti-Inflammatory Agents, Non-Steroidal; Buprenorphine; Cats; Female; Hysterectomy; Injections, Intraperitoneal; Meloxicam; Ovariectomy; Pain Measurement; Pain, Postoperative; Prospective Studies; Thiazines; Thiazoles; Treatment Outcome

Postoperative pain associated with removal of mandibular third molars has been documented from moderate to severe during the first 24 hours after surgery, with pain peaking between 6 and 8 hours when a conventional local anesthetic is used. Dental pain is largely inflammatory, and evidence-based medicine has shown that nonsteroidal anti-inflammatory drugs are the best analgesics for dental pain. The aim of this study was to compare the analgesic, anti-inflammatory and anti-trismus effect of a single dose of diclofenac and meloxicam after mandibular third molar extraction.. A total of 36 patients were randomized into two treatment groups, each with 18 patients, using a series of random numbers: Group A, was administered 100 mg of diclofenac; and Group B, 15 mg of meloxicam. Drugs were administered orally 1 hour prior to surgery. We evaluated pain intensity, analgesic consumption, swelling, as well as trismus.. The results of this study showed that patients receiving 15 mg of meloxicam had less postoperative pain (P=0.04) and better aperture than those receiving 100 mg of diclofenac (P=0.03). The meloxicam group presented less swelling than diclofenac group; however, significant statistical differences were not observed.. Data of this double-blind, randomized, parallel-group clinical trial demonstrated that patients receiving 15 mg of preoperative meloxicam had a better postoperative analgesia and anti-trismus effect compared with who were given 100 mg of diclofenac after third molar extractions.

Topics: Adolescent; Adult; Anti-Inflammatory Agents, Non-Steroidal; Diclofenac; Double-Blind Method; Edema; Female; Humans; Male; Meloxicam; Molar, Third; Pain, Postoperative; Thiazines; Thiazoles; Tooth Extraction; Trismus; Young Adult

Breast cancer surgery is known to cause severe acute postoperative pain, which can persist for a long time. We administered nefopam preventively to patients undergoing lumpectomy with axillary lymph node dissection or sentinel lymph node biopsy, and evaluated its efficacy on acute and chronic postoperative pain.Enrolled patients were assigned to the nefopam (n = 41) or the control (n = 42) group. Before initiating the operation, 20 mg of nefopam was given to the patients of the nefopam group, and normal saline was used in the control group. Ketorolac was given at the end of surgery, and meloxicam was prescribed in the postoperative period to all patients in both groups. Pain was assessed using a numerical rating scale (NRS), and the rescue analgesic drug was given when the NRS was >5. Implementation of postoperative chemotherapy, radiotherapy (RT), or hormone therapy was evaluated.The NRS of postoperative pain was significantly lower in the nefopam than in the control group in the postanesthetic care unit (4.5 ± 2.2 vs 5.7 ± 1.5, respectively; P = 0.01), at postoperative 6 h (3.0 ± 1.6 vs 4.5 ± 1.3, respectively; P < 0.001), and at postoperative 24 h (3.1 ± 1.1 vs 3.8 ± 1.5, respectively; P = 0.01) with reduced use of rescue analgesic drugs. Significantly fewer patients suffered from chronic postoperative pain in the nefopam than in the control group at postoperative 3 months (36.6% vs 59.5%, P = 0.04). Considering only the cohort without postoperative adjuvant RT, the difference in the proportion of patients reporting chronic pain increased (23.5% in the nefopam group vs 61.5% in the control group, P = 0.04).Preventive nefopam was helpful in reducing the acute postoperative pain, with reduced use of rescue analgesic drugs, and it contributed to reduced occurrence of chronic pain at postoperative 3 months after breast cancer surgery.

Topics: Acute Pain; Adult; Aged; Analgesics, Non-Narcotic; Axilla; Breast Neoplasms; Chemoradiotherapy, Adjuvant; Chronic Pain; Cyclooxygenase Inhibitors; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Ketorolac; Mastectomy, Segmental; Meloxicam; Middle Aged; Nefopam; Pain Measurement; Pain, Postoperative; Preoperative Care; Prospective Studies; Sentinel Lymph Node Biopsy; Thiazines; Thiazoles

Duloxetine is effective for chronic musculoskeletal and neuropathic pain, but there are insufficient data to recommend the use of antidepressants for postoperative pain. The authors hypothesized that administration of duloxetine for 15 days would reduce pain with ambulation at 2 weeks after total knee arthroplasty.. In this triple-blinded, randomized, placebo-controlled trial, patients received either duloxetine or placebo for 15 days, starting from the day of surgery. Patients also received a comprehensive multimodal analgesic regimen including neuraxial anesthesia, epidural analgesia, an adductor canal block, meloxicam, and oxycodone/acetaminophen as needed. The primary outcome was the pain score (0 to 10 numeric rating scale) with ambulation on postoperative day 14.. One hundred six patients were randomized and analyzed. On day 14, duloxetine had no effect on pain with ambulation; mean pain was 3.8 (SD, 2.3) for placebo versus 3.5 (SD, 2.1) for duloxetine (difference in means [95% CI], 0.4 [-0.5 to 1.2]; P = 0.386). Symptoms potentially attributable to duloxetine discontinuation at study drug completion (nausea, anxiety) occurred among nine patients (duloxetine) and five patients (placebo); this was not statistically significant (P = 0.247). Statistically significant secondary outcomes included opioid consumption (difference in mean milligram oral morphine equivalents [95% CI], 8.7 [3.3 to 14.1], P = 0.002 by generalized estimating equation) over the postoperative period and nausea on day 1 (P = 0.040). There was no difference in other side effects or in anxiety and depression scores.. When included as a part of a multimodal analgesic regimen for knee arthroplasty, duloxetine does not reduce subacute pain with ambulation.

Topics: Acetaminophen; Adult; Aged; Analgesia, Epidural; Analgesics; Anti-Inflammatory Agents, Non-Steroidal; Arthroplasty, Replacement, Knee; Double-Blind Method; Drug Combinations; Drug Therapy, Combination; Duloxetine Hydrochloride; Female; Humans; Male; Meloxicam; Middle Aged; Oxycodone; Pain, Postoperative; Thiazines; Thiazoles; Treatment Outcome

Movement-evoked pain is more severe than pain at rest and is likely to interfere more with functional recovery after surgery.. To compare triple vs. double nonopioid perioperative analgesic regimens in women undergoing abdominal hysterectomy.. A randomised, parallel design, double-blind controlled trial.. A single-centre trial. Study period from November 2009 to July 2013.. Adults (>18 years) of American Society of Anesthesiologists' status 1 to 2 scheduled for abdominal hysterectomy.. Patients were randomised to one of four study treatment groups: acetaminophen, meloxicam and gabapentin (AMG); acetaminophen and meloxicam; acetaminophen and gabapentin; and meloxicam and gabapentin. In addition to intravenous patient-controlled opioid analgesia, study treatments were administered for 48 h, starting 1 h preoperatively.. The primary outcome was cough-evoked pain. Secondary outcomes included pain at rest, during sitting and peak expiration, opioid consumption, side effects, peak expiratory flow rate, timed up and go test (TUG), and modified Brief Pain Inventory (mBPI).. Interim analysis indicated a minimal chance of demonstrating superiority of the triple regimen group over all three double regimen groups if the trial were to be recruited to planned sample size. Thus, the trial was prematurely terminated for futility. All four analgesic regimens were well tolerated. Exploratory analyses revealed consistent significant negative correlations between pain and TUG and between pain and interference with activity, walking and sleep.. This trial failed to demonstrate substantial benefits with the addition of a third nonopioid analgesic to three different double-drug regimens. Further research is needed that will more definitively support expanding multimodal analgesic practices. Our results demonstrate consistent correlations between evoked pain and functional outcomes further emphasising the need for improved analgesic regimens that will accelerate postsurgical functional recovery.. International Standard Randomised Controlled Trial Number Register 12723675.

Topics: Acetaminophen; Adult; Amines; Analgesia, Patient-Controlled; Analgesics, Opioid; Cyclohexanecarboxylic Acids; Double-Blind Method; Drug Therapy, Combination; Early Termination of Clinical Trials; Female; Gabapentin; gamma-Aminobutyric Acid; Humans; Hysterectomy; Meloxicam; Middle Aged; Morphine; Ontario; Pain Measurement; Pain, Postoperative; Recovery of Function; Thiazines; Thiazoles; Time Factors; Treatment Outcome

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in veterinary medicine. Robenacoxib is a NSAID with high selectivity for the cyclo-oxygenase-2 enzyme. In this study, the efficacy and safety of robenacoxib were evaluated in a prospective, randomised, active- and placebo-controlled masked clinical trial in 147 cats undergoing orthopaedic surgery. Cats were randomised into two treatment groups: Group 1, robenacoxib (2 mg/kg) administered via subcutaneous (s.c.) injection before surgery, followed by robenacoxib tablets (1-2.4 mg/kg) administered post-operatively for approximately 9 days (n = 101) and Group 2, meloxicam (0.3 mg/kg) administered s.c. before surgery, followed by placebo tablets administered post-operatively for approximately 9 days (n = 46). Cats were assessed using numerical rating scales (NRSs) by clinicians before surgery and at 3, 8, 22 and 28 hours after surgery and at the final visit (VF on approximately Day 10), and daily by their owners from Day 1 to the VF.. The primary end point was the global investigator score which was the sum of clinician NRSs for posture, behaviour and pain on palpation/manipulation. The efficacy of the single robenacoxib injection, assessed during 3 to 22 hours, was statistically non-inferior to meloxicam, with a relative efficacy of 1.029 (95% confidence interval, 0.847-1.231). No significant differences were detected during the follow-up treatment with robenacoxib tablets for approximately 9 days compared with placebo via clinician assessments at 28 hours and the VF, or in owner assessments on Days 1-VF. There were no significant differences in frequencies of reported adverse events, clinical observations and haematology or clinical chemistry variables between the groups.. Single s.c. injection of robenacoxib before surgery had non-inferior efficacy compared with meloxicam in controlling post-operative pain and inflammation in cats undergoing orthopaedic surgery. Follow-up treatment with oral robenacoxib tablets for approximately 9 days was well tolerated, but there were no differences in the efficacy scores after Day 1 compared with the group receiving meloxicam s.c. followed by placebo control.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Cat Diseases; Cats; Diphenylamine; Female; Hydrocortisone; Inflammation; Male; Meloxicam; Orthopedic Procedures; Pain, Postoperative; Perioperative Period; Phenylacetates; Thiazines; Thiazoles

The benefit of pre and post-operative administration of non-steroidal anti-inflammatory drugs for the relief of post-operative pain and control of inflammation in horses following orthopaedic surgery has not been previously investigated in controlled clinical field trials, and the utility of such treatment is a matter of ongoing dispute. Recently the utility of post-operative pain management was emphasized. It was therefore our aim to determine the efficacy of meloxicam in horses following partial resection of fractured splint bones. This condition was selected since the limited extent of the insult and the defined surgical intervention allowed the conduct of a randomized, double blinded, placebo-controlled, parallel group, multi-centre clinical field study in a homogenous patient population.. Sixty-six client owned horses requiring unilateral partial splint bone resection were recruited in 15 centres in Germany and were allocated in a 1:1 ratio to receive meloxicam, 0.6 mg/kg for 5 days. Lameness at trot grades prior to surgery were similar in the meloxicam and placebo treatment groups but were significantly lower in the meloxicam group on day 6 post surgery. Clinical scores for soft tissue swelling and assessment of analgesic and anti-inflammatory efficacy by the investigators at the end of the study were significantly better for the meloxicam compared to the placebo group. No treatment-related adverse reactions were observed.. The administration of meloxicam i.v. once prior to surgery followed by once daily oral administration for four consecutive days is efficacious for the control of post-operative pain and inflammation in horses undergoing orthopaedic surgery.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Female; Horse Diseases; Horses; Inflammation; Male; Meloxicam; Orthopedics; Pain, Postoperative; Thiazines; Thiazoles

The analgesic and antihyperalgesic effects of dipyrone, meloxicam or a dipyrone-meloxicam combination were compared in dogs undergoing elective ovariohysterectomy. In a double-blinded, prospective, randomised design, 40 bitches premedicated with intramuscular pethidine (4 mg/kg) and anaesthetised with isoflurane received one of four intravenous treatments (n = 10 per group) before ovariohysterectomy: control (physiological saline), meloxicam (0.2 mg/kg), dipyrone (25 mg/kg) or dipyrone-meloxicam (25 mg/kg and 0.2 mg/kg, respectively). Glasgow composite measure pain scale (GCMPS) and mechanical nociceptive thresholds (MNT) were assessed before anaesthesia and at 1, 2, 3, 4, 6, 8, 12 and 24 h postoperatively. Rescue analgesia (0.5 mg/kg morphine) was administered intramuscularly if the GCMPS was ≥3. The GCMPS and MNT did not differ among groups. The frequency of rescue analgesia was significantly (P <0.05) lower in the dipyrone group (30%) than in controls (50%), but there were no significant differences from the control group in bitches treated with meloxicam (70%) or dipyrone-meloxicam (40%). There was a significant reduction in the total number of rescue treatments in the dypyrone (n = 5) and dipyrone-meloxicam (n = 5) groups when compared with the control (n = 17) and meloxicam (n = 19) groups. Meloxicam and dipyrone-meloxicam significantly reduced the percentage of animals exhibiting severe pain during MNT measurements (30% and 0%, respectively) compared with the control group (50%). Dipyrone produced superior analgesia (reduced morphine consumption), while meloxicam produced better antihyperalgesia (fewer episodes of severe pain) in contrast to controls. When used in tandem, the beneficial effects were combined.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Dipyrone; Dogs; Double-Blind Method; Drug Therapy, Combination; Female; Hyperalgesia; Hysterectomy; Meloxicam; Ovariectomy; Pain, Postoperative; Thiazines; Thiazoles

Pain management and welfare are increasingly prevalent concerns within animal agriculture. Analgesics may alleviate pain and inflammation associated with castration of beef cattle. This study was conducted to elucidate the effects of surgical castration on the acute inflammatory response and immunomodulation and whether concurrent oral administration of meloxicam (1 mg/kg BW) would alter these responses. On d -1, crossbred bull calves ( = 30; initial BW = 227.4 ± 10.3 kg) were fitted with indwelling jugular catheters and rectal temperature (RT) recording devices, placed into individual stanchions, and randomly assigned to 1 of 3 treatments. Treatment application occurred at h 0 and consisted of 1) intact bull calves treated with sham castration (CON), 2) bulls surgically castrated without meloxicam administration (CAS), and 3) bulls surgically castrated with oral meloxicam (1 mg/kg BW) administration (MEL). Blood samples were collected at 0.5-h intervals from h -2 to 4, 1.0-h intervals from h 4 to 8, and 12-h intervals from h 12 to 72. Serum was analyzed for cortisol and haptoglobin (Hp) concentrations using ELISA. Whole blood was analyzed for complete blood counts at -2, 0, 2, 4, 6, 8, 12, 24, 36, 48, 60, and 72 h, and RT was recorded in 5-min intervals. Postcastration RT was greatest for MEL (39.04), intermediate for CAS (38.99), and least for CON (38.93°C; ≤ 0.01). Serum cortisol was increased ( < 0.001) for CAS (12.3) and MEL (11.3) compared with CON (6.7 ng/mL) during the postcastration period. At 0.5 and 1.5 h, cortisol concentration was greater in CAS and MEL than CON, whereas at 2 and 2.5 h, cortisol concentration was greatest for CAS, intermediate for MEL, and least for CON (treatment × time, < 0.001). Total white blood cell ( ≤ 0.04), lymphocyte ( ≤ 0.02), and monocyte ( ≤ 0.002) counts were greatest for CAS, intermediate for MEL, and least for CON. Administration of MEL reduced ( ≤ 0.002) eosinophil counts during the postcastration period when compared with CON and CAS. The change in serum Hp, relative to baseline values, was reduced for MEL at 36 ( < 0.01) and 60 h ( ≤ 0.03), and the overall Hp concentration was least for MEL ( < 0.001). Oral administration of meloxicam at the time of castration reduced the acute inflammatory response in castrates, as evidenced by a reduction in Hp and certain leukocyte concentrations; it also caused a delayed increase in RT. Further research is needed to determine if this reduced acute inflammatory response w

Topics: Administration, Oral; Analgesics; Animals; Anti-Inflammatory Agents, Non-Steroidal; Cattle; Haptoglobins; Hydrocortisone; Inflammation; Male; Meloxicam; Orchiectomy; Pain; Pain, Postoperative; Thiazines; Thiazoles

Pre-emptive analgesia may reduce pain, accelerate recovery and shorten the duration of hospitalization. The present study aims to compare the preemptive analgesic effects of meloxicam and celecoxib in patients undergoing lower limb surgery.. In this double blind randomized clinical trial, 70 patients, undergoing lower extremity surgery, entered in the study; thirty five patients were randomly allocated to either group using random allocation software. Meloxicam (15 mg) was administered orally to one group two hours before the surgical onset. The other group was treated with oral celecoxib (400 mg) two hours before the operation. Pain severity was compared between the two groups.. Upon admission to Recovery Room, the mean pain severity was not significantly different between the two groups. At one and two hours following surgery the mean pain severity was significantly higher in celecoxib group. However, 6 hours following surgery mean pain severity was higher with meloxicam administration. Pain severity was not significantly different in the two groups, 12 and 24 hours following surgery.. The analgesic effect of celecoxib seems to cover longer duration than meloxicam; but, meloxicam appears to be a stronger analgesic in shorter time interval.

Topics: Administration, Oral; Adult; Anti-Inflammatory Agents, Non-Steroidal; Celecoxib; Cyclooxygenase 2 Inhibitors; Double-Blind Method; Female; Humans; Male; Meloxicam; Middle Aged; Pain, Postoperative; Severity of Illness Index; Thiazines; Thiazoles; Time Factors; Young Adult

Approved analgesic compounds in cattle are not currently available in the United States due to the lack of validated pain assessment methods and marker residue depletion studies. In this study, we compared the pharmacokinetic parameters and effect of preemptive analgesics administered to calves subjected to dehorning with local anesthesia. Holstein steers were randomly assigned to receive one of the following treatments per os (PO) or intravenously (IV) (n = 8/group): meloxicam (1 mg/kg PO), gabapentin (15 mg/kg PO), meloxicam (1 mg/kg), and gabapentin (15 mg/kg) PO, flunixin (2.2 mg/kg IV), or a placebo. Plasma drug, haptoglobin, substance P (SP) concentrations, serum cortisol concentrations, ocular thermography, mechanical nociceptive threshold (MNT), and average daily gain (ADG) were evaluated. Data were analyzed using mixed-effects models and noncompartmental pharmacokinetic analysis. Meloxicam, gabapentin, and meloxicam with gabapentin at the present doses did not reduce cortisol concentrations. Analgesic-treated calves had significantly lower plasma SP concentrations and improved ADG compared with controls. Flunixin calves had reduced circulating cortisol compared with controls. Meloxicam-treated calves showed an increase in MNT at two horn bud sites compared with the other treatments. Analgesics improved ADG and reduced biomarkers of pain, but effects differed by compound and route of administration.

Topics: Amines; Anesthetics, Local; Animals; Anti-Inflammatory Agents, Non-Steroidal; Cattle; Cattle Diseases; Clonixin; Cyclohexanecarboxylic Acids; Dairying; Gabapentin; gamma-Aminobutyric Acid; Horns; Male; Meloxicam; Pain Measurement; Pain, Postoperative; Thiazines; Thiazoles

Since all analgesics currently available for use in dogs have been associated with some adverse effects, the search for an effective analgesic that does not cause harm is important. This study investigated the postoperative analgesic effects of ozone administered either intrarectally or into acupoints in bitches undergoing ovariohysterectomy (OH). Twenty-four healthy adult bitches were randomly assigned to one of the three treatments 10 min after sedation, as follows: 0.2mg/kg of intramuscular (IM) meloxicam (M); rectal insufflation of 10 mL of 30 μg/mL ozone (OI), or acupoint injection of 0.5 mL ozone (30 μg/mL; OA). Following sedation with acetylpromazine, anaesthesia was induced with propofol and fentanyl and maintained with isoflurane/O2. Pain was assessed using the modified Glasgow pain scale (MGPS) and the visual analogue scale (VAS) on the day before surgery, before anaesthesia, and at 1, 2, 4, 6, 8, 12 and 24h after surgery. Rescue analgesia was performed using 0.5mg/kg of morphine IM if MGPS was >3.33 points. No statistically significant differences in pain scales were found among the three analgesic protocols or the time points in each group (P>0.05). Two dogs treated with OA required rescue analgesia. Meloxicam, rectal insufflation of ozone and ozone injected into acupoints provided satisfactory analgesia for 24h in bitches undergoing elective OH. Ozone had no measurable adverse effects and is an alternative option to promote pain relief.

Topics: Acupuncture Points; Administration, Rectal; Animals; Anti-Inflammatory Agents, Non-Steroidal; Dog Diseases; Dogs; Female; Hysterectomy; Meloxicam; Ovariectomy; Ozone; Pain, Postoperative; Thiazines; Thiazoles

To compare the postoperative analgesic effects of intravenous (IV) lidocaine, meloxicam, and their combination in dogs undergoing ovariohysterectomy.. Prospective, randomized, double-blind, controlled clinical trial.. Twenty-seven dogs aged (mean ± SD) 16.1 ± 7.5 months and weighing 22.4 ± 17.9 kg scheduled for ovariohysterectomy.. Anaesthesia was induced with propofol and maintained with isoflurane. Dogs (n = 9 in each group) were allocated to receive just prior to and during surgery one of the following regimens: M group, 0.2 mg kg(-1) IV meloxicam then a continuous rate infusion (CRI) of lactated Ringer's at 10 mL kg(-1) hour(-1); L group, a bolus of lidocaine (1 mg kg(-1) IV) then a CRI of lidocaine at 0.025 mg kg(-1) minute(-1); and M + L group, both the above meloxicam and lidocaine treatments. Pain and sedation were scored, and venous samples taken for serum cortisol and glucose measurement before and at intervals for 12 hours after anaesthesia. Pain scores were assessed using a multi-parameter subjective scoring scale (cumulative scale 0-21) by three observers. The protocol stated that dogs with a total score exceeding 9 or a sub-score above 3 in any one category would receive rescue analgesia. Sedation was scored on a scale of 0-4.. There were no significant differences in subjective pain scores, serum cortisol, and glucose concentrations between the three groups. The highest pain score at any time was 5, and no dog required rescue analgesia. None of the three regimens caused any observable side effects during or after anaesthesia. At 1 and 2 hours after extubation dogs in group L were significantly more sedated than in the other two groups.. This study suggests that, with the scoring system used, IV lidocaine and meloxicam provide similar and adequate post-operative analgesia in healthy dogs undergoing ovariohysterectomy.

Topics: Analgesia; Analgesics; Animals; Dogs; Double-Blind Method; Drug Therapy, Combination; Female; Hysterectomy; Infusions, Intravenous; Lidocaine; Meloxicam; Ovariectomy; Pain Measurement; Pain, Postoperative; Postoperative Period; Thiazines; Thiazoles

To compare the effects of tramadol alone, or in combination with dipyrone or meloxicam, on postoperative pain and analgesia requirement after unilateral mastectomy with or without ovariohysterectomy in dogs.. Prospective, randomized, clinical study.. Twenty seven bitches undergoing unilateral mastectomy with or without ovariohysterectomy.. Anesthesia was induced with propofol and maintained with isoflurane and a constant rate infusion of morphine. Before the end of surgery, dogs were randomly assigned to receive intravenous tramadol alone (3 mg kg(-1), group T), combined with dipyrone (30 mg kg(-1), group TD) or meloxicam (0.2 mg kg(-1), group TM). Dogs received additional doses of tramadol (groups T and TM) or tramadol with dipyrone (group TD) at 8 and 16 hours after extubation. Postoperative pain was assessed by a blinded observer before anesthesia (baseline) and at 1, 2, 3, 4, 6, 8, 12, 16 and 24 hours after extubation using a visual analog scale (VAS) and a modified Glasgow scale. Rescue analgesia (morphine, 0.5 mg kg(-1)) was administered if the Glasgow pain score was >3.5.. There were no significant differences among groups in pain scores evaluated by the VAS or the Glasgow scale. In groups T, TD and TM, pain scores were significantly higher than at baseline for 6, 8 and 2 hours, respectively. Rescue analgesia was administered to 3/9, 2/9 and 1/9 dogs in groups T, TD and TM, respectively (p > 0.05) [Correction added on 15 August 2013, after first online publication: 'T, TM and TD' was changed to 'T, TD and TM'.].. Under the conditions of this study, tramadol alone or in combination with dypyrone or meloxicam provided effective analgesia for 24 hours in most dogs after unilateral mastectomy with or without ovariohysterectomy. Further evaluation of combination therapies is needed in larger groups of dogs.

Topics: Analgesia; Analgesics, Opioid; Animals; Anti-Inflammatory Agents, Non-Steroidal; Dipyrone; Dogs; Drug Therapy, Combination; Female; Hysterectomy; Mastectomy; Meloxicam; Ovariectomy; Pain Measurement; Pain, Postoperative; Thiazines; Thiazoles; Tramadol

Postoperative pain and its management following fistulation surgery in cattle are poorly understood. The purpose of this study was to compare 2 nonsteroidal antiinflammatory drugs (NSAID) as potential postoperative pain management treatments following the first stage of a 2-stage fistulation surgery. A randomized complete block design trial was conducted in dry Holstein cows (n=10) following fistulation surgery. Ketoprofen (3mg/kg of body weight i.m.) was administered on the day of surgery and 24 h later, whereas meloxicam (0.5 mg/kg of body weight s.c.) was administered once only on the day of surgery. Outcomes evaluated at 0, 2, 9, 24, 26, and 33 h postsurgery were heart rate, respiration rate, rectal temperature, and infrared temperature around the surgical site. Outcomes evaluated on the day of surgery and d 1 following surgery and compared with the average for the 4d before surgery were lying activity (total lying time, total time spent lying on the left side, and percentage of time lying on the left side) and feed intake. A difference was observed in dry matter intake on d 1 but this effect was not different on d 0 compared with presurgical averages. A difference was observed in time spent lying on the left side and a difference was observed in heart rate following the first stage of fistulation surgery compared with presurgical averages. The infrared temperature readings around the surgical site were significantly greater in the hours following surgery compared with presurgical averages. The respiration rate increased over time after 24h postsurgery compared with presurgical values. Although it was clear that the surgery is painful, the drug effects were more difficult to explain. On d 0 and 1, the meloxicam-treated cows ate 3 kg more but spent 101 min/d less time lying on their left side compared with ketoprofen-treated cows. The first stage of a 2-stage fistulation surgery was considered painful based on changes in heart rate, respiration rate, infrared temperature readings, dry matter intake, and time spent lying on the left side. It is clear that left flank surgery is painful and that NSAID can improve outcomes associated with that pain, but we cannot make recommendations as to which NSAID to choose based on these results.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Cattle; Digestive System Surgical Procedures; Eating; Female; Ketoprofen; Meloxicam; Pain, Postoperative; Rumen; Temperature; Thiazines; Thiazoles

NSAID administration is often chosen as a method of minimizing pain and discomfort for nonhuman primates. Of concern when using NSAID is the potential for decreased platelet aggregation due to the inhibition of cyclooxygenases 1 and 2. In both dogs and humans, the use of NSAID that are selective for cyclooxygenase 2, like meloxicam, minimizes the inhibition of platelet aggregation in comparison to nonselective NSAID, like aspirin, that inhibit both isoforms of cyclooxygenase. In this study, we measured platelet aggregation in rhesus macaques (n = 6) by using the impedance method on a multiple-electrode aggregometer at baseline, at 1 and 4 d after initiating treatment with aspirin or meloxicam, and after a washout period. There was no statistical difference between aggregation at baseline and after 1 or 4 d of meloxicam treatment, but platelet aggregation decreased after both 1 and 4 d of aspirin therapy. Our data suggest that clinically significant postoperative hemorrhage is unlikely in rhesus macaques briefly treated with meloxicam.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Arachidonic Acid; Aspirin; Cyclooxygenase Inhibitors; Humans; Macaca mulatta; Male; Meloxicam; Pain, Postoperative; Platelet Aggregation; Species Specificity; Thiazines; Thiazoles

Behavioural responses and the effect of lidocaine and meloxicam on behaviour of piglets after castration were studied. A total of 144 piglets of 2 to 5 days of age were allocated to one of six treatments: castration (CAST), castration with lidocaine (LIDO), castration with meloxicam (MELO), castration with lidocaine and meloxicam (L + M), handling (SHAM) and no handling (NONE). Behaviour was observed for 5 days after the procedure, growth until weaning was recorded and characteristics of the castration wound noted. MELO piglets showed significantly (P < 0.05) more no pain-related behaviour than CAST and LIDO at the afternoon after castration, and were not significantly different from SHAM and NONE. LIDO piglets showed an increase (P < 0.001) in tail wagging, lasting for 3 days. This increase was not seen in L + M piglets. The occurrence of several behaviours changed with age, independent of treatment. A treatment effect on growth was not found. Wound healing was rapid in all treatments, but thickening of the heal was observed in several piglets, suggesting perturbation in the cicatrization process. Our study showed a pain-relieving effect of meloxicam after castration. Local anaesthesia resulted in piglets performing more tail wagging during the first few days after castration, which was prevented by administering meloxicam in combination with local anaesthesia.

Topics: Anesthetics, Local; Animal Welfare; Animals; Anti-Inflammatory Agents, Non-Steroidal; Behavior, Animal; Injections, Intramuscular; Injections, Subcutaneous; Lidocaine; Male; Meloxicam; Orchiectomy; Pain, Postoperative; Postoperative Period; Sus scrofa; Thiazines; Thiazoles; Wound Healing

To compare the pre-emptive analgesic effectiveness of 15 mg of meloxicam and 50 mg of tramadol after mandibular third molar surgery.. This pilot study was a double-blind, randomized, parallel-group clinical trial. The patients were randomized into 2 treatment groups, each with 15 patients, by use of a series of random numbers: group A was administered 15 mg of meloxicam intramuscularly (IM) 50 minutes before the surgery and group B was given 50 mg of tramadol IM 50 minutes before the surgery. We evaluated pain intensity, analgesic consumption, swelling, and trismus.. The group receiving 15 mg of meloxicam IM showed differences in pain intensity evaluated by the area under the curve of the visual analog scale and total analgesic consumption when compared with the group receiving 50 mg of tramadol IM.. The patients receiving 15 mg of preoperative meloxicam had less pain intensity and total analgesic consumption than those receiving 50 mg of preoperative tramadol.

Topics: Adolescent; Adult; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Edema; Female; Humans; Injections, Intramuscular; Ketorolac; Male; Mandible; Meloxicam; Molar, Third; Pain Measurement; Pain, Postoperative; Pilot Projects; Postoperative Complications; Premedication; Thiazines; Thiazoles; Time Factors; Tooth Extraction; Tooth, Impacted; Tramadol; Trismus; Young Adult

The aim of this pilot study was to evaluate pre-emptive analgesia using the combination tramadol plus meloxicam compared with each individual drug alone for the reduction of pain after extraction of third molars. Fifty-one patients were randomised into three groups (n=17 in each), using a series of random numbers: the first group was given tramadol 25mg and meloxicam 7.5mg; the second tramadol 50mg, and the third meloxicam 15 mg, all intramuscularly. Treatments were prepared in identical syringes by an independent investigator and were given immediately. The teeth were removed 50 min after the analgesics had been given. Intensity of pain, consumption of analgesics, and adverse effects were evaluated. The intensity of pain was evaluated using a visual analogue scale (VAS) and the area under the curve of the VAS showed significant differences amongst the groups. In conclusion, the study showed that the combination of tramadol 25mg and meloxicam 7.5mg had an analgesic effect similar to that of meloxicam 15 mg, but both were better than tramadol 50mg for relief of pain after the extraction of mandibular third molars.

Topics: Adolescent; Adult; Analgesics, Opioid; Analysis of Variance; Anti-Inflammatory Agents; Area Under Curve; Double-Blind Method; Drug Combinations; Female; Humans; Male; Meloxicam; Molar, Third; Pain Measurement; Pain, Postoperative; Pilot Projects; Thiazines; Thiazoles; Tramadol

The objective of this study was to evaluate the efficacy and tolerability of robenacoxib, a selective cyclooxygenase-2 inhibitor, for the treatment of post-operative pain and inflammation in cats. The study was a prospective, multi-centre, randomised, blinded, non-inferiority design clinical study to compare robenacoxib to meloxicam. Ninety-six cats undergoing surgery at eight centres in Japan were allocated randomly to receive a single s.c. injection of robenacoxib (2 mg/kg, n=67) or meloxicam (0.3 mg/kg, n=29) shortly before induction of anaesthesia. Most cats underwent soft tissue surgery (n=87), mainly ovariectomy (n=68). Post-operative pain and inflammation were assessed at 3, 8 and 22 h after recovery from anaesthesia using numerical rating scales. For the primary efficacy endpoint (total clinician score), robenacoxib had significantly better efficacy than meloxicam, the relative efficacy ratio being 1.47 (95% confidence interval 1.19-1.78, P=0.0003). For the secondary efficacy endpoints, robenacoxib was superior to meloxicam when assessed on the basis of posture, behaviour, pain on palpation and overall pain control, while meloxicam was superior with respect to wound heat. No cat in either group required rescue analgesia therapy. In tolerability assessments, pain during injection and pain and inflammation at the injection site 22 h after recovery from anaesthesia were rated significantly less with robenacoxib compared to meloxicam. Both treatments were well tolerated on the basis of clinical observations and blood tests, with no significant differences between groups. In conclusion, single pre-operative administration of robenacoxib was well tolerated and had superior efficacy to meloxicam in reducing post-operative pain in cats.

Topics: Animal Welfare; Animals; Cats; Cyclooxygenase 2 Inhibitors; Diphenylamine; Female; Inflammation; Injections, Subcutaneous; Japan; Male; Meloxicam; Ovariectomy; Pain, Postoperative; Phenylacetates; Preoperative Care; Prospective Studies; Thiazines; Thiazoles

To assess the analgesic effects of 2 doses of meloxicam on the degree of postoperative orthopedic pain in pigeons.. 21 domestic pigeons (Columba livia).. In each bird, a standardized osteotomy of 1 femur was performed and the fracture was immobilized with an intramedullary pin. Birds were randomly allocated to receive saline (0.9% NaCl) solution (control) or meloxicam (0.5 mg/kg [low dose] or 2.0 mg/kg [high dose]). The first treatment was administered i.m. after surgery was completed. Subsequent treatments were administered p.o. every 12 hours for 9 days. Degree of postoperative pain was assessed for the first 4 days after surgery by use of 3 methods: an electronic perch for assessment of weight-bearing load differential of the pelvic limbs, 4 pain scales, and analysis of video-recorded partial ethograms for bird activity and posture.. No significant differences were observed between the control group and the low-dose meloxicam group in any tested variable. The high-dose meloxicam group had a greater degree of weight bearing on the affected limb from the second to the fourth postoperative day as well as lower pain scores for at least the first 2 postoperative days, compared with the other groups. Return to presurgical behavior was achieved faster in pigeons that received high-dose meloxicam than in the other groups. No adverse effects were observed.. Administration of meloxicam at 0.5 mg/kg appeared ineffective in minimizing postoperative orthopedic pain in pigeons, but the 2.0 mg/kg dose provided quantifiable analgesia that appeared safe in this species in experimental conditions.

Topics: Analgesia; Animals; Anti-Inflammatory Agents, Non-Steroidal; Bird Diseases; Bone Diseases; Columbidae; Femoral Fractures; Male; Meloxicam; Motor Activity; Osteotomy; Pain Measurement; Pain, Postoperative; Thiazines; Thiazoles; Weight-Bearing

A randomized, double-blind clinical trial was carried out involving 25 patients scheduled for the removal of symmetrically positioned lower third molars in separate procedures. Either 100 mg of nimesulide or 7.5 mg of meloxicam was administered 1 hour before surgery and every 12 hours after surgery for 2 days. Evaluations were carried out in the preoperative period as well as on the second and seventh days after surgery. Objective and subjective parameters were recorded for comparison purposes. The patients having received nimesulide had less of a need for additional pain medication in the first 48 hours and had lower pain scale values (P < 0.05). There was less trismus in the meloxicam group (P > 0.05). Postoperative swelling was lower in the nimesulide group (P < 0.05). All measurements on the second day were lower in the nimesulide group (P < 0.001), and only one of these parameters was lower on the seventh day in the nimesulide group, distance from the lower edge of the tragus to the lip commissure on the operated side (P = 0.009, P < 0.001) compared with another group. Nimesulide proved effective in controlling pain and swelling after surgical removal of the lower third molars, with few adverse effects. Meloxicam proved effective in diminishing trismus.

Topics: Adolescent; Adult; Aged; Cyclooxygenase 2 Inhibitors; Double-Blind Method; Female; Humans; Male; Meloxicam; Middle Aged; Molar, Third; Pain Measurement; Pain, Postoperative; Prospective Studies; Sulfonamides; Thiazines; Thiazoles; Tooth, Impacted; Trismus

One hundred female cats undergoing routine ovariohysterectomy under midazolam-medetomidine-ketamine anaesthesia were included in a blinded, randomised, prospective clinical study to compare postoperative analgesia produced by four analgesic drug combinations given preoperatively (n = 25 per group). A secondary aim was to assess the effects in kittens and pregnant animals. Buprenorphine 180 µg/m(2) or butorphanol 6 mg/m(2) were given with either carprofen 4 mg/kg (groups BUPC and BUTC, respectively) or meloxicam 0.3 mg/kg (groups BUPM or BUTM, respectively). Medetomidine was not antagonised. A simple, descriptive scale (SDS; 0-4), a dynamic and interactive visual analogue scale (DIVAS; 0-100 mm) and mechanical nociceptive thresholds (MT; 2.5-mm diameter probe) were used to evaluate postoperative pain. All pain scores were low (DIVAS <10 mm, SDS <2 and MT >10 N) and there were no significant differences between the groups. It was concluded that all protocols provided adequate analgesia and when used with midazolam-medetomidine-ketamine are effective for routine feline ovariohysterectomy.

Topics: Analgesics, Opioid; Anesthesia, Obstetrical; Anesthetics, Combined; Animals; Behavior, Animal; Buprenorphine; Carbazoles; Cat Diseases; Cats; Double-Blind Method; Female; Humans; Hysterectomy; Meloxicam; Ovariectomy; Pain, Postoperative; Postoperative Care; Pregnancy; Premedication; Prenatal Exposure Delayed Effects; Prospective Studies; Thiazines; Thiazoles; Time Factors; Treatment Outcome

The present study addresses the questions whether on-farm use of local anaesthesia with lidocaine leads to a reduction in pain responses during castration, and whether the non-steroidal anti-inflammatory drug meloxicam improves technical performance after castration of piglets. Five treatments were included in the study: (1) castration without anaesthesia or analgesia (CAST), (2) castration after local anaesthesia with lidocaine (LIDO), (3) castration after administration of meloxicam (MELO), (4) castration after lidocaine and meloxicam (L + M) and (5) sham castration (SHAM). To reduce litter influences, each treatment was present in each of the 32 litters (n = 32 per treatment). During castration, vocalizations were recorded continuously. Blood samples were collected 15 min before and 20 min after castration for determination of plasma levels of total cortisol, glucose, lactate and creatine kinase (CK). Mortality was registered and piglets were weighed several times to calculate growth. Several aspects of vocalizations during castration showed consistent and significantly different levels in CAST compared with LIDO, L + M and SHAM. CAST piglets squealed longer, louder and higher. Vocalizations of MELO piglets most resembled those of CAST. An increase in cortisol was seen in all treatments. However, in SHAM piglets this increase was significantly lower than in the other treatments. LIDO piglets showed a significantly smaller increase in plasma cortisol levels compared with CAST and MELO. L + M piglets differed significantly only from the SHAM group. Lactate levels differed significantly between LIDO and MELO, the level in LIDO being decreased after castration. In the other treatments an increase was measured. No treatment effects were found in plasma glucose and CK levels, nor in growth and mortality of the piglets. In conclusion, on the basis of vocalizations and plasma cortisol, local anaesthesia with lidocaine reduces pain responses in piglets during castration. A positive effect of meloxicam on technical performance was not found.

Topics: Anesthetics, Local; Animals; Anti-Inflammatory Agents, Non-Steroidal; Injections, Intramuscular; Injections, Subcutaneous; Lidocaine; Male; Meloxicam; Orchiectomy; Pain, Postoperative; Stress, Physiological; Swine; Thiazines; Thiazoles; Vocalization, Animal

Buprenorphine is commonly used as (part of) postoperative analgesic treatment with dosage dependent side-effects such as pica behaviour. No strict consensus exists about the optimal dosing interval of buprenorphine, as its duration of action has been described as being in the range of 6-12 h. In this study, dosing intervals of 8 h (thrice-a-day) and 12 h (twice-a-day) for buprenorphine in a multimodal analgesic strategy (concurrent administration of a non-steroidal anti-inflammatory drug) were compared on food intake, weight and side-effects (gnawing on plastic Petri dishes and growth rate, indicative of pica behaviour) in rats. The food intake and weight of both intervals were comparable, as the animals from the twice-a-day group did not lose more weight or consumed less food during the analgesic period. The rats from the thrice-a-day group suffered from more side-effects, as the growth rate was decreased and more plastic was gnawed on. It is recommended to carefully evaluate analgesic and side-effects when using buprenorphine. When side-effects are observed, the possibility of increasing the dosing interval of buprenorphine should be explored. In this study, increasing the dosing interval of buprenorphine in a multimodal analgesic regimen resulted in reduced unwanted side-effects, without increasing weight loss or decreasing food intake. Although this is suggestive of provision of comparable analgesia, future studies including more pain-related readout parameters to assess the effect of the dosing interval on analgesic efficacy are recommended.

Topics: Analgesics, Opioid; Animals; Anti-Inflammatory Agents, Non-Steroidal; Buprenorphine; Drug Therapy, Combination; Electrodes, Implanted; Feeding Behavior; Injections, Subcutaneous; Male; Meloxicam; Neurosurgical Procedures; Pain, Postoperative; Pica; Postoperative Care; Rats; Rats, Wistar; Thiazines; Thiazoles; Time Factors; Weight Gain

The aim of this study was to determine the viability and cardiorespiratory effects of the association of epidural alpha-2 adrenergic agonists and lidocaine for ovariohysterectomy (OH) in bitches. Forty-two bitches were spayed under epidural anesthesia with 2.5 mg/kg body weight (BW) of 1% lidocaine with adrenaline (CON) or in association with 0.25 mg/kg BW of xylazine (XYL), 10 μg/kg BW of romifidine (ROM), 30 μg/kg BW of detomidine (DET), 2 μg/kg BW of dexmedetomidine (DEX), or 5 μg/kg BW of clonidine (CLO). Heart rate (HR), respiratory rate (fR) and arterial pressures were monitored immediately before and every 10 min after the epidural procedure. Blood gas and pH analysis were done before, and at 30 and 60 min after the epidural procedure. Animals were submitted to isoflurane anesthesia if they presented a slightest sign of discomfort during the procedure. Time of sensory epidural block and postoperative analgesia were evaluated. All animals in CON and DEX, 5 animals in ROM and CLO, 4 animals in XYL, and 3 in DET required supplementary isoflurane. All groups, except CLO, showed a decrease in HR. There was an increase in arterial pressures in all groups. Postoperative analgesia lasted the longest in XYL. None of the protocols were totally efficient to perform the complete procedure of OH; however, xylazine provided longer postoperative analgesia than the others.

Topics: Adrenergic alpha-2 Receptor Agonists; Analgesics, Opioid; Anesthesia, Epidural; Animals; Anti-Inflammatory Agents, Non-Steroidal; Dogs; Female; Hypnotics and Sedatives; Hysterectomy; Lidocaine; Meloxicam; Morphine; Ovariectomy; Pain, Postoperative; Thiazines; Thiazoles

The objective of this study was to compare the efficacy of meloxicam when given by intra-articular (IA) and subcutaneous (SC) routes of administration for postoperative analgesia versus a placebo for dogs undergoing stifle surgery. Twenty-five dogs with cranial cruciate ligament rupture (CCLR) were randomly assigned to one of three treatment groups, each with nine dogs, before surgical repair of twenty-seven stifles using a modified lateral retinacular imbrication technique. Group 1 dogs received IA administration of meloxicam and SC placebo. Group 2 dogs received IA placebo and SC meloxicam. Group 3 dogs received IA and SC administration of placebo. Dogs were assessed for pain by blinded observers using a visual analog scale (VAS), a numerical pain scoring system (NPS), and measurement of pain threshold using an algometer applied to the affected stifle. Assessments were made prior to pre-medication, postoperatively at the time of extubation, and at 1, 2, 4, 6, 8, 10, 12, 16, 20, and 24 hours following extubation. The results did not identify any significant effect of treatment between groups on the VAS data, algometer readings, or NPS data. Significantly increased VAS scores and decreased algometer readings were noted from preoperative to postoperative times. No differences were noted in early postoperative pain between dogs treated with IA meloxicam, SC meloxicam, or placebo. While intra-articular non-steroidal anti- inflammatory drug administration has shown efficacy in joint surgery for people, we did not find any evidence to support its use in dogs undergoing repair of CCLR.

Topics: Analgesics; Animals; Dog Diseases; Dogs; Injections, Intra-Articular; Injections, Subcutaneous; Meloxicam; Pain, Postoperative; Stifle; Thiazines; Thiazoles

To assess efficacy and tolerability of robenacoxib for control of pain and inflammation in dogs undergoing orthopedic surgery.. 140 client-owned dogs.. A multicenter, prospective, randomized, blinded field trial was conducted to compare robenacoxib (97 dogs) and meloxicam (43 dogs). After randomization, each dog received an initial dose (robenacoxib, 2 mg/kg; meloxicam, 0.2 mg/kg) via SC injection before surgery and daily doses (robenacoxib, 1 to 2 mg/kg; meloxicam, 0.1 mg/kg) administered orally for up to 15 days after surgery. Efficacy was assessed by veterinarians and owners via numeric rating scales and visual analogue scales. Safety was assessed on the basis of reported adverse events, clinical signs, results of hematologic and biochemical analyses, and buccal mucosa bleeding times.. Treatment groups were balanced with respect to baseline and demographic data. Both treatments provided similar adequate pain control, as assessed with a modified Glasgow pain scale as the primary end point and supported by secondary end points in evaluations conducted by veterinarians and owners. For the primary end point, the ratio of the reciprocal of the scores for robenacoxib to meloxicam was 1.16 (95% confidence interval, 0.98 to 1.37). No dogs required rescue analgesia. Both treatments were associated with only minor adverse events, which were not necessarily related to the administered treatments and did not affect mucosal bleeding times.. Robenacoxib provided efficacy and tolerability similar to those of meloxicam for the management of perioperative pain and inflammation in dogs undergoing orthopedic surgery.

Topics: Administration, Oral; Analgesics; Animals; Diphenylamine; Dog Diseases; Dogs; Female; Inflammation; Infusions, Subcutaneous; Male; Meloxicam; Orthopedic Procedures; Pain, Postoperative; Phenylacetates; Thiazines; Thiazoles

This study compared the efficacy of nimesulide and meloxicam in the control of pain, swelling and trismus, following the extraction of impacted inferior third molars. Twenty patients with two impacted inferior third molars, in similar positions, were selected. The patients were designated randomly to the meloxicam group (MEL: 7.5mg twice a day for 5 days) or the nimesulide group (NIM: 100mg for 5 days). Following the extractions, swelling was more pronounced in the MEL group than in the NIM group (P0.05). At the 72-h evaluation, reduction was significantly larger in mouth opening in the MEL group compared with the NIM group (P<0.05). In conclusion, pain control was similar in both treatment groups. NIM was more effective than MEL in the control of swelling and trismus following the extraction of impacted lower third molars.

Topics: Cross-Over Studies; Cyclooxygenase Inhibitors; Edema; Female; Humans; Male; Meloxicam; Molar, Third; Pain Measurement; Pain, Postoperative; Sulfonamides; Thiazines; Thiazoles; Tooth Extraction; Tooth, Impacted; Trismus; Young Adult

To investigate the efficacy of meloxicam or tolfenamic acid administered preoperatively and postoperatively (five days in total) to cats undergoing surgical fracture repair.. Eighty-eight otherwise healthy cats were matched according to fracture site and then randomly allocated to one of two groups, receiving 0·2 mg/kg meloxicam by subcutaneous injection (group M) or 1·5 to 3 mg/kg tolfenamic acid orally (group T) before anaesthesia. Analgesia was continued with 0.05 mg/kg oral meloxicam once daily or 1·5 to 3 mg/kg oral tolfenamic acid twice daily for four days postoperatively. Pain was assessed by a blinded observer using visual analogue scales and a functional limb score. The drug administrator assessed feed intake and palatability of the treatment.. Data from 66 cats were analysed. Visual analogue scale pain scores and functional limb scores decreased over time in both groups but were not significantly different between treatments. Feed intake was similar in both groups. Meloxicam was significantly more palatable than tolfenamic acid on all treatment days.. Meloxicam and tolfenamic acid demonstrated comparable analgesia, without clinically observable side effects. Meloxicam may be associated with superior compliance in clinical practice due to the higher palatability and once daily treatment resulting in better ease of administration.

Topics: Analgesia; Analgesics; Animals; Cats; Female; Fractures, Bone; Lameness, Animal; Male; Meloxicam; ortho-Aminobenzoates; Pain Measurement; Pain, Postoperative; Postoperative Care; Thiazines; Thiazoles

Hysterectomy and spinal surgery inpatient trials suggest favorable interactions between cyclooxgenase-2 inhibitors and gabapentin/pregabalin on postoperative days 1-2. We present the first trial of meloxicam-gabapentin combination after outpatient laparoscopic cholecystectomy.. This was a randomized, double-blind trial comparing daily oral administration of 1) meloxicam 15 mg, 2) gabapentin 1200-1600 mg, and 3) a combination of the two starting 1 h before until 2 days after surgery. Primary outcomes included day of surgery spontaneous and movement-evoked pain. Secondary outcomes included pain on Days 1, 2, and 30, adverse effects, opioid consumption, spirometry, pain-related interference, hospital discharge time, return to work time, and patient satisfaction.. On the day of surgery, 60-min rest pain (0-10 numerical rating scale +/- sd) was significantly lower (P < 0.05) with gabapentin alone (2.0 +/- 1.6) versus meloxicam alone (3.6 +/- 2.1). Observed pain differences between the combination (2.9 +/- 2.1) and gabapentin alone were fairly small in favor of gabapentin alone (P > 0.05). Secondary analyses indicated that nausea was significantly less frequent with the combination (24%) versus the single-drug meloxicam (57%) only.. Although nausea was reduced with combination therapy, this trial provides little or no support for the combined use of meloxicam and gabapentin for pain relief on the day of surgery. This suggests that perioperative analgesic polypharmacy may not always be necessary or appropriate.

Topics: Adult; Aged; Aged, 80 and over; Ambulatory Surgical Procedures; Amines; Analgesics, Non-Narcotic; Analgesics, Opioid; Cholecystectomy, Laparoscopic; Cyclohexanecarboxylic Acids; Double-Blind Method; Drug Therapy, Combination; Female; Gabapentin; gamma-Aminobutyric Acid; Humans; Male; Meloxicam; Middle Aged; Movement; Oxygen Inhalation Therapy; Pain Measurement; Pain, Postoperative; Patient Satisfaction; Spirometry; Thiazines; Thiazoles; Treatment Outcome; Young Adult

The hypothesis was that Visual Analog Scale (VAS) scores would be lower, and mechanical wound thresholds (MWT) higher, in cats receiving tolfenamic acid compared to those receiving placebo in the postoperative period following elective ovariohysterectomy.. Sixty-nine client-owned cats.. A prospective, randomized, blinded and placebo-controlled study was performed in cats which underwent ovariohysterectomy following preoperative tolfenamic acid, meloxicam, or placebo. A second dose of the same analgesic was administered 24 hours postoperatively. Assessments were made 1-hour before induction and 1, 2, 4, 6, 22, and 25 hours postoperatively. Pain was assessed by a blinded observer using Numerical Rating (NRS) and VAS scales. The MWT were measured using a force-measuring device. Group comparison was performed by using one-way ANOVA and chi-squared test for qualitative and quantitative data, respectively, and a mixed model for repeated measurements (p < 0.05).. Sixty-five cats were included in the study. There were no differences between groups at baseline. There was a treatment effect on the NRS scores at 6, 22 and 25 hours. The meloxicam group was less painful than controls at 6 and 22 hours; both treatment groups were less painful than controls at 25 hours. There were no differences between groups in VAS for pain or sedation. The number of animals receiving rescue analgesia did not differ between groups. There was a treatment effect on MWT; thresholds in both treatment groups were significantly higher than that observed in controls at all time points.. Preoperative tolfenamic acid or meloxicam reduced wound sensitivity following ovariohysterectomy in the cat.. Tolfenamic acid and meloxicam administered preoperatively provided a similar analgesic effect in the postoperative period lasting 24 hours. Mechanical thresholds may be a better way of evaluating postoperative analgesia provided by nonsteroidal anti-inflammatory drugs in cats.

Topics: Analgesics; Animals; Cats; Female; Hysterectomy; Meloxicam; ortho-Aminobenzoates; Ovariectomy; Pain Measurement; Pain, Postoperative; Thiazines; Thiazoles

To characterize physiologic responses of ball pythons (Python regius) following a minor surgical procedure and investigate the effects of 2 commonly used analgesics on this response.. 15 healthy ball pythons.. Snakes were randomly assigned to receive 1 of 3 treatments: meloxicam (0.3 mg/kg [0.14 mg/lb]; n = 5), butorphanol (5 mg/kg [2.3 mg/lb]; 5), or saline (0.9% NaCl) solution (5) before catheterization of the vertebral artery. Plasma concentrations of catecholamines and cortisol, blood pressure, heart rate, and blood gas values were measured at various times for 72.5 hours after catheterization. The 72.5-hour point was defined as baseline.. Heart rate of ball pythons increased significantly during the first hour following surgery. Mean plasma epinephrine concentration increased slightly at 2.5 hours after surgery, whereas mean plasma cortisol concentration increased beginning at 1.5 hours, reaching a maximum at 6.5 hours. Mean blood pressure increased within the first hour but returned to the baseline value at 2.5 hours after surgery. After 24.5 hours, blood pressure, heart rate, and plasma hormone concentrations remained stable at baseline values. There were no significant differences in values for physiologic variables between snakes that received saline solution and those that received meloxicam or butorphanol.. Measurement of physiologic variables provides a means of assessing postoperative pain in snakes. Meloxicam and butorphanol at the dosages used did not decrease the physiologic stress response and did not appear to provide analgesic effects in ball pythons.

Topics: Analgesics, Opioid; Animals; Biomarkers; Blood Gas Analysis; Boidae; Butorphanol; Epinephrine; Heart Rate; Hydrocortisone; Meloxicam; Pain, Postoperative; Preoperative Care; Thiazines; Thiazoles; Time Factors

To compare the opioid sparing effect of meloxicam, diclofenac, and placebo after abdominal hysterectomy.. This study was conducted at the Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia from February 2004 to November 2006. Women of American Society of Anesthesiologist's classification I or II of ages 25-60 years scheduled for abdominal hysterectomy were included. Those with significant systemic disease or contraindication to opioid or non-steroidal anti-inflammatory drugs were excluded from the study. All patients received general anaesthesia and intravenous (IV) morphine, and were intubated and ventilated for the operation. The patients were randomized and rectally received meloxicam 15 mg, diclofenac 100 mg, or placebo suppository. Patients, anesthetists, and nurses managing the patients postoperatively were blinded to these drugs. In the recovery room, IV patient controlled morphine was commenced. The information sought included patient characteristics age, weight, duration of operation, and doses of morphine consumed in 24 hours.. Seventy-five patients 25 in each group participated in this study and only 5 patients dropped out. There was no difference in age and body weight of the patients, and duration of the operation. All underwent either total or sub-total hysterectomy. The mean SD morphine consumption in the 24-hour postoperative period was 37.7 (11.1) mg for the diclofenac group, 40.1 (7.8) mg for the meloxicam group, and 45.2 (9.8) mg for the placebo group. As compared to placebo, the mean morphine consumption in diclofenac but not in meloxicam group was significantly (p<0.05) reduced.. Our study demonstrates a significant opioid sparing effect after abdominal hysterectomy with diclofenac, but not with meloxicam.

Topics: Adult; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Diclofenac; Double-Blind Method; Female; Humans; Hysterectomy; Meloxicam; Middle Aged; Pain, Postoperative; Thiazines; Thiazoles

To investigate the effect of the administration of a single dose of meloxicam pre-emptively on postoperative pain management in patients who underwent inguinal hernia repair under local anaesthesia.. Fifty patients who underwent inguinal hernia repair under local anaesthesia during the period November 2005 to May 2006 were recruited into the study prospectively. The patients were randomized to two groups regarding administration and non-administration of pre-emptive meloxicam. The postoperative visual analogue pain scale (VAS) values at 4, 8, 12 and 24 hours and analgesic needs of the patients were recorded. No difference was found between the groups in terms of age, gender, hernia localization and type. The VAS values of the patients regarding their pain severity were evaluated at 4, 8, 12 and 24 hours and were significantly lower in the group which received meloxicam pre-emptively (p = 0.001, 0.0001, 0.003 and 0.0001 respectively). The need for non-steroidal anti-inflammatory drug was also found to be significantly lower (p = 0.0001).. Postoperative pain severity and hence analgesic requirement were significantly decreased in the patients who received meloxicam pre-emptively. Single dose pre-emptive meloxicam seems to be an effective analgesic therapy for patients undergoing inguinal hernia repair under local anaesthesia. It thereby improves patients comfort and should be considered for use in outpatient surgery.

Topics: Anesthesia, Local; Anti-Inflammatory Agents, Non-Steroidal; Female; Hernia, Inguinal; Humans; Male; Meloxicam; Middle Aged; Pain Measurement; Pain, Postoperative; Prospective Studies; Thiazines; Thiazoles

Fifty patients were scheduled to undergo removal of symmetrically positioned lower third molars in two separate appointments. Meloxicam 7.5 or 15 mg was once daily administered in a double-blind, randomized and crossover manner after the surgery for 4 days. Objective and subjective parameters were recorded for comparison of postoperative courses. Patients treated with 7.5mg meloxicam who underwent osteotomy reported higher pain scores at 1.5, 3, 4, 10, 12 and 16 h (P<0.05) and ingested a greater amount of rescue analgesic medication (P<0.05) than those who did not require osteotomy. A higher percentage of patients who underwent osteotomy medicated with 7.5mg meloxicam needed rescue medication as compared to those who did not require osteotomy (P<0.05). There was a similar mouth opening at suture removal compared with preoperative values for both doses (P>0.05). There were no significant differences concerning swelling observed on the 2nd or 7th postoperative days in comparison with baseline (P>0.05) between the two doses. Pain, trismus and swelling after lower third molar removal not requiring osteotomy can be successfully controlled by a dose regimen of 7.5mg meloxicam once daily. For more aggressive extractions 15 mg meloxicam is advisable.

Topics: Administration, Oral; Adult; Analysis of Variance; Anti-Inflammatory Agents, Non-Steroidal; Cross-Over Studies; Dose-Response Relationship, Drug; Double-Blind Method; Edema; Female; Humans; Male; Meloxicam; Molar, Third; Osteotomy; Pain, Postoperative; Range of Motion, Articular; Statistics, Nonparametric; Thiazines; Thiazoles; Tooth Extraction; Tooth, Impacted; Trismus

The analgesic and anti-inflammatory efficacy of tenoxicam and meloxicam were evaluated in this double-masked, randomized, prospective study by analyzing pain scores and the need for rescue-analgesic agents following dental implant surgery.. One hundred patients, in whom 241 dental implants were placed, were divided into two groups. For 4 days beginning the day before surgery, the first group received meloxicam, 15 mg daily, and the second group received tenoxicam, 20 mg daily, followed by 1 hour preoperatively and for 2 days thereafter. Pain intensity was rated by the subjects based on a visual analog scale on the operation day and on the following 6 days. The patients were recommended to use a rescue analgesic if the pain score was > or =4. Postoperative complications, such as edema, hematoma, infection, severe pain, paresthesia, or gastrointestinal complaints, were also noted.. Statistical analysis revealed that 54% of patients in the tenoxicam group and 66% of patients in the meloxicam group used rescue analgesics on day 1. However, the difference between the groups was not significant (chi(2) = 1.05; P = 0.30). The relationship between the reduction of consumption and time was not significant in either group (Z = 0.84; P = 0.40). The relationship between the use of rescue analgesics and the number of implants placed was not significant. Among patients who reported postoperative complications, there was not a statistically significant difference between the groups (chi(2) = 0.04; P = 0.84).. Meloxicam and tenoxicam exhibited a similar analgesic and anti-inflammatory efficacy in the present investigation.

Topics: Analgesics; Cyclooxygenase 2 Inhibitors; Dental Implantation, Endosseous; Double-Blind Method; Female; Humans; Male; Meloxicam; Middle Aged; Pain Measurement; Pain, Postoperative; Piroxicam; Premedication; Prospective Studies; Thiazines; Thiazoles

The efficacy of the selective cyclooxygenase-2 (COX-2) inhibitor meloxicam for treatment of postoperative oral surgical pain was assessed in a randomized controlled trial. Patients undergoing unilateral mandibular 3rd molar extraction surgery were allocated to 3 groups, A, B and C. After oral premedication of meloxicam 10 mg in group A, ampiroxicam 27 mg in group B and placebo in group C, surgery was completed within 30 min under local anaesthesia using 2% lidocaine. For postoperative pain relief the patients were allowed to take oral loxoprofen (60 mg per tablet). Postoperative pain was evaluated at the clinic on the 1st, 7th and 14th postoperative day (POD) using a visual analogue scale (VAS), as was the number of loxoprofen tablets consumed, and the results were compared among the 3 groups with statistical significance of P<0.05. VAS scores on 1 POD were significantly lower in group A than in group C. Loxoprofen consumption on the day of surgery and 1 POD was significantly lower in group A than in group C (P<0.01). Total analgesic consumption was significantly lower in groups A and B than in group C (P<0.02). The COX-2 inhibitor, meloxicam 10 mg used for premedication reduced postoperative pain compared with control in oral surgery.

Topics: Administration, Oral; Adult; Analysis of Variance; Anesthesia, Local; Anti-Inflammatory Agents, Non-Steroidal; Cyclooxygenase 2 Inhibitors; Double-Blind Method; Female; Humans; Male; Meloxicam; Molar, Third; Pain Measurement; Pain, Postoperative; Phenylpropionates; Premedication; Prospective Studies; Thiazines; Thiazoles; Tooth Extraction

To investigate pain relieving efficacy of six agents which are used in postoperative pain management after otolaryngologic operations.. 120 adult patients (63 females, 57 males; mean age 36; range 18 to 76 years) were included in the study. The same intraoperative anesthesia was applied to all the patients. The following medications were randomly given to the patients who declared pain in the sixth hour after the operation: naproxen sodium, meloxicam, rofecoxib, paracetamol, dipyrone, and etodolac in proper dosage to form groups of 20 for each medication. Before and after the application of pain reliever tablets, visual analog scale (VAS) and numerical rating scale (NRS) were used to inquire whether the agents were effective in relieving pain. ANOVA (one way), paired t-test, Kruskal-Wallis, and Student's t-test were used as statistical methods. p values <0.05 were considered to indicate statistical significance.. All the groups had similar VAS values before medication (p>0.05). When VAS values of each group were assessed after medication, it was recorded that naproxen sodium (p=0.020) and meloxicam (p=0.001) were effective. When the difference of NRS values between "before medication" and "after medication" was compared among the groups, all the agents significantly changed NRS values, but no inter-group differences were found (p>0.05).. In terms of NRS scores, the effectiveness of six different analgesic agents which had been used to reduce postoperative pain was confirmed. Moreover, naproxen sodium and meloxicam were found to be more effective than the other agents when taken in the postoperative period for the adult patients according to VAS values.

Topics: Acetaminophen; Adolescent; Adult; Aged; Analgesics; Dipyrone; Etodolac; Female; Humans; Lactones; Male; Meloxicam; Middle Aged; Naproxen; Otorhinolaryngologic Surgical Procedures; Pain Measurement; Pain, Postoperative; Postoperative Period; Sulfones; Thiazines; Thiazoles; Treatment Outcome

To determine analgesic efficacy and adverse effects of preemptive administration of meloxicam or butorphanol in cats undergoing onychectomy or onychectomy and neutering.. Randomized controlled study.. 64 female and 74 male cats that were 4 to 192 months old and weighed 1.09 to 705 kg (2.4 to 15.5 lb).. Cats received meloxicam (0.3 mg/kg [0.14 mg/lb], s.c.) or butorphanol (0.4 mg/kg [0.18 mg/lb], s.c.) 15 minutes after premedication and prior to anesthesia. A single blinded observer measured physiologic variables, assigned analgesia and lameness scores, and withdrew blood samples for each cat at baseline and throughout the 24 hours after surgery. Rescue analgesia (butorphanol, 0.4 mg/kg, i.v. or s.c.) or administration of acepromazine (0.025 to 0.05 mg/kg [0.011 to 0.023 mg/lb], i.v.) was allowed.. Meloxicam-treated cats were less lame and had lower pain scores. Cortisol concentration was higher at extubation and lower at 1, 5, and 12 hours in the meloxicam-treated cats. Fewer meloxicam-treated cats required rescue analgesia at 3, 5, 12, and 24 hours after extubation. General impression scores were excellent or good in 75% of meloxicam-treated cats and 44% of butorphanol-treated cats. There was no treatment effect on buccal bleeding time; PCV and BUN concentration decreased in both groups, and glucose concentration decreased in meloxicam-treated cats.. Preoperative administration of meloxicam improved analgesia for 24 hours without clinically relevant adverse effects in cats that underwent onychectomy or onychectomy and neutering and provided safe, extended analgesia, compared with butorphanol.

Topics: Analgesics, Non-Narcotic; Analgesics, Opioid; Animals; Butorphanol; Cats; Female; Heart Rate; Hoof and Claw; Hysterectomy; Injections, Subcutaneous; Male; Meloxicam; Orchiectomy; Ovariectomy; Pain Measurement; Pain, Postoperative; Preoperative Care; Respiration; Thiazines; Thiazoles; Treatment Outcome

The purpose of the study was to evaluate the effect of preoperative administration of meloxicam, a non-steroidal anti-inflammatory drug used for pain control, on primary haemostasis in dogs. Twenty healthy female dogs undergoing elective ovariohysterectomy were enrolled in the study. Sixty minutes before pre-anaesthesia, a single dose of meloxicam (0.2 mg/kg) was randomly administered intravenously (IV) to 10 dogs (treatment group) while control dogs received an equivalent volume of saline solution IV. Platelet aggregation, buccal mucosa bleeding time, platelet count and haematological indices were measured at 0, 1, 6 and 24 h after administration of meloxicam. Since significant differences between groups were not observed for any of the measured parameters, preoperative administration of meloxicam may be used for pain control before elective ovariohysterectomy in healthy dogs, without compromising primary haemostasis.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Bleeding Time; Blood Chemical Analysis; Dogs; Elective Surgical Procedures; Female; Hysterectomy; Injections, Intravenous; Meloxicam; Mouth Mucosa; Ovariectomy; Pain, Postoperative; Platelet Aggregation; Preoperative Care; Thiazines; Thiazoles; Treatment Outcome

To compare the peri- and post-operative (72 hours) analgesic effects of injectable and orally administered carprofen and meloxicam for ovariohysterectomy in dogs.. Prospective, randomized clinical study.. Forty-three dogs undergoing elective ovariohysterectomy.. Dogs were randomly assigned to receive pre-operative carprofen, meloxicam or sterile saline by subcutaneous injection. Pre-anaesthetic medication was intramuscular acepromazine (0.02 mg kg(-1)) and methadone (0.2 mg kg(-1)). Anaesthesia was induced with either thiopentone or propofol injected to effect, and maintained with isoflurane in oxygen. Visual analogue scores (VAS) for pain and sedation were recorded at 1, 2, 3, 4 and 6 hours following tracheal extubation. Oral medication with the same treatment was continued post-operatively for 3 days, with VAS scores for pain being recorded before, and 2 hours after treatment on each day. Differences between group age, body mass, duration of general anaesthesia, time from treatment injection to tracheal extubation and time from treatment injection to first oral treatment were analysed using one-way analysis of variance and Kruskal-Wallis test. Visual analogue scores for pain and sedation were analysed using a re-randomization method. The significance level was set at p < 0.05.. Meloxicam-treated subjects had lower mean VAS than the control group at 2 and 6 hours following tracheal extubation. Control group VAS were more varied than meloxicam scores (at 6 hours) and carprofen scores (at 3 and 6 hours). On the first post-operative day, pre- to post-treatment VAS scores decreased significantly after meloxicam. On day 3, scores in the meloxicam-treated group were significantly lower than control values after treatment. Changes in pre- to post-treatment VAS were greater in animals receiving either meloxicam or carprofen compared with those given saline.. Both carprofen and meloxicam provided satisfactory analgesia for 72 hours following ovariohysterectomy in dogs.

Topics: Analgesics, Non-Narcotic; Anesthesia; Animals; Carbazoles; Dogs; Female; Hysterectomy; Meloxicam; Ovariectomy; Pain Measurement; Pain, Postoperative; Prospective Studies; Thiazines; Thiazoles; Treatment Outcome

This study was conducted to evaluate the analgesic efficacy of meloxicam in abdominal hysterectomy.. The study population consisted of 52 patients scheduled for total abdominal hysterectomy who were ASA 1 or 2 physical status female. Patients were allocated randomly to receive orally either 15 mg of meloxicam (Group M, n = 27) or placebo (Group P, n = 25) before anesthesia induction. After intravenous administration of 1.5 mg kg(-1) of tramadol, anesthesia was induced with an intravenous loading dose of 1-2 mg kg(-1) propofol. Anesthesia was maintained on intravenous infusion of propofol at 6-12 mg kg(-1) h plus tramadol at 1 mg kg(-1) h(-1), vecuronium, and a 2:1 nitrous oxide-oxygen mixture.. The relative propofol consumption was lower in Group M than in Group P, (p < 0.05). The time for analgesic rescue decreased in the order Group M > Group P (p < 0.01). The degree of sedation was similar between the groups (p > 0.05) and the visual analog scores (10-cm scale) and verbal rating scale data differences were present in the first 2 h only (p < 0.05). When side-effects were evaluated nausea and vomiting were found to be lower in group M than in group P (p < 0.05).. Preemptive meloxicam provided better postoperative analgesia than placebo.

Topics: Administration, Oral; Analgesics, Non-Narcotic; Anesthetics, Intravenous; Drug Administration Schedule; Female; Humans; Hysterectomy; Meloxicam; Middle Aged; Pain Measurement; Pain, Postoperative; Propofol; Thiazines; Thiazoles; Treatment Outcome

Thirty-two dogs undergoing operations to repair a torn cranial cruciate ligament or a fractured long bone were randomly allocated to one of two treatment groups in a study on postoperative pain. Sixteen of the dogs were given 4 mg/kg carprofen and the other 16 were given 0.2 mg/kg meloxicam subcutaneously before the operation. The signs of pain shown by the animals were assessed for 24 hours on a visual analogue scale, a discontinuous scoring system, and a score based on five behavioural and physiological variables. The dogs' heart and respiratory rates and their mean arterial blood pressures were also measured non-invasively at each assessment. Blood samples were taken before the surgery and 24 hours after it, and the concentrations of urea and creatinine were measured in plasma. Both drugs were effective in relieving the signs of pain for up to 24 hours in all the dogs. There were no significant changes in the concentrations of urea and creatinine, and no adverse effects were reported during the postoperative period.

Topics: Animals; Anterior Cruciate Ligament; Carbazoles; Cyclooxygenase Inhibitors; Dog Diseases; Dogs; Drug Administration Schedule; Female; Fractures, Bone; Male; Meloxicam; Orthopedics; Pain, Postoperative; Thiazines; Thiazoles

Successful management of endodontic pain represents a continuing challenge. The purpose of this randomized, double-blind, placebo-controlled, parallel-group trial was to compare the pain reducing effect of oral preparations of meloxicam, piroxicam, and placebo in endodontic emergency patients. A total of 51 patients who presented to the Tehran University endodontic clinic and one private dental clinic were invited to participate. Patients were asked to evaluate their pretreatment pain with a visual-analog scale. After root canal therapy they were randomly assigned to one of three groups: meloxicam, piroxicam, or placebo. Each patient was sent home with a visual-analog scale to fill out at 8 and 24 h after completion of therapy. The results of this study showed no significant differences between efficacy of meloxicam, piroxicam, and placebo, but a significant effect of the time factor in reducing postoperative pain in all treatment groups was observed.

Topics: Adult; Analysis of Variance; Anti-Inflammatory Agents, Non-Steroidal; Chi-Square Distribution; Cyclooxygenase 2; Cyclooxygenase 2 Inhibitors; Cyclooxygenase Inhibitors; Double-Blind Method; Humans; Isoenzymes; Meloxicam; Membrane Proteins; Pain Measurement; Pain, Postoperative; Piroxicam; Prostaglandin-Endoperoxide Synthases; Regression Analysis; Root Canal Therapy; Thiazines; Thiazoles; Toothache

In this prospective randomized study we tested the hypothesis that use of more cyclo-oxygenase 2 (COX 2)-selective non-steroidal anti-inflammatory drugs (NSAIDs) can reduce perioperative blood loss compared with non-selective NSAIDs.. Data from 200 patients who underwent total hip replacement were studied. Two NSAIDs were compared: indomethacin 50 mg (n = 82) and meloxicam 15 mg (n = 86). Both NSAIDs were given orally 1 h before surgery.. The two groups were not different with respect to age, gender, ASA class or duration of surgery. When indomethacin was used preoperatively, intraoperative blood loss was 623 +/- 243 mL (mean +/- SD) and postoperative blood loss 410 +/- 340 mL. After meloxicam, these values were 524 +/- 304 mL and 358 +/- 272 mL, respectively. Total perioperative blood loss after meloxicam was 17% (P < 0.05) less than that observed after indomethacin.. Perioperative blood loss after meloxicam is less than after indomethacin. These in vivo findings are consistent with in vitro results using selective COX 2 NSAIDs.

Topics: Aged; Anti-Inflammatory Agents, Non-Steroidal; Arthroplasty, Replacement, Hip; Blood Loss, Surgical; Cyclooxygenase 2; Cyclooxygenase 2 Inhibitors; Cyclooxygenase Inhibitors; Female; Humans; Indomethacin; Isoenzymes; Male; Meloxicam; Membrane Proteins; Middle Aged; Pain Measurement; Pain, Postoperative; Perioperative Care; Prospective Studies; Prostaglandin-Endoperoxide Synthases; Thiazines; Thiazoles; Time Factors

Eighty female cats presented for ovariohysterectomy were randomly allocated to one of two treatment groups in this assessor-blinded trial. After pre-anaesthetic assessment, the cats were premedicated with acepromazine (0.1 mg/kg). Anaesthesia was induced with thiopentone and maintained with halothane in oxygen. Forty cats received carprofen (4 mg/kg subcutaneously) and 40 received meloxicam (0.3 mg/kg subcutaneously) after anaesthetic induction. Following routine flank ovariohysterectomy the cats were assessed using visual analogue scale scores for pain and sedation over a 20-hour study period. Blood samples were taken before sedation and at 20 hours for serum biochemistry (urea, creatinine, alanine aminotransferase and aspartate aminotransferase). There were no significant differences between the groups for pain and sedation scores. Serum biochemistry values were similar between the groups, with some differences within groups between the pre-sedation and 20-hour values. One cat in the carprofen group and two cats in the meloxicam group required rescue analgesia with intramuscular morphine (0.2 mg/kg).

Topics: Analgesics, Non-Narcotic; Animals; Anti-Inflammatory Agents, Non-Steroidal; Carbazoles; Cat Diseases; Cats; Female; Hysterectomy; Injections, Subcutaneous; Meloxicam; Ovariectomy; Pain, Postoperative; Thiazines; Thiazoles

To compare preoperative administration of meloxicam and butorphanol to perioperative administration of butorphanol alone for control of postoperative signs of pain in dogs.. 40 client-owned dogs scheduled for surgical repair of a cranial cruciate ligament rupture.. Group-1 dogs received butorphanol (0.2 mg/kg, IV) and meloxicam (0.2 mg/kg, IV) just prior to surgery. Group-2 dogs received butorphanol just prior to surgery (0.2 mg/kg, IV) and at incision closure (0.1 mg/kg, IV). Pain assessment began 1 to 2 hours before surgery and from extubation until 24 hours after surgery by obtaining the following measurements: the visual analog scale (VAS) score, cumulative pain score (CPS), adjusted cumulative pain score, modified cumulative pain score, and the adjusted modified cumulative pain score (AMCPS). Serum cortisol concentration was measured between 12 to 24 and between 1 to 2 hours prior to surgery, and at 30 minutes, and 1, 2, 4, 8, 18, and 24 hours after extubation.. No significant differences between treatment groups were observed in CPS or VAS score. At 8, 9, 10, and 11 hours after extubation, meloxicam-butorphanol-treated dogs had a significantly lower AMCPS, compared with butorphanol-alone-treated dogs. Total serum cortisol concentration (area under the curve) during the measurement period was significantly lower in meloxicam-butorphanol-treated dogs, compared with butorphanol-alone treated dogs.. Preoperative single dose administration of meloxicam-butorphanol is equivalent to or slightly better than the administration of 2 perioperative doses of butorphanol for the control of postoperative signs of pain in dogs.

Topics: Analgesics, Opioid; Animals; Anterior Cruciate Ligament; Area Under Curve; Butorphanol; Cyclooxygenase Inhibitors; Dogs; Drug Therapy, Combination; Hydrocortisone; Injections, Intravenous; Meloxicam; Pain Measurement; Pain, Postoperative; Stifle; Thiazines; Thiazoles

To distinguish between local and systemic drug effects, we compared pain scores, analgesic consumption and plasma concentrations after local vs i.v. administration of meloxicam 7.5 mg in patients with inguinal hernia repair.. In a double-blind, randomized study 56 patients received either local or i.v. meloxicam 7.5 mg. Postoperative pain was assessed with a visual analogue scale (VAS) at rest, on mobilization, and on coughing, the need for supplementary analgesics (fentanyl i.v. and/or acetaminophen-codeine tablets) was recorded, and blood samples were drawn during 24 hr after meloxicam administration.. No significant differences were found between groups with respect to pain scores, or in the consumption of supplementary analgesics. Following local application of meloxicam, the peak plasma concentration (C(max)) of 0.5 +/- 0.2 mg*L(-1) achieved after 1.8 +/- 0.5 hr was much lower than the C(max) of 2.5 +/- 0.9 mg*L(-1) achieved immediately after i.v. administration (P <0.05). Mean meloxicam plasma concentration after infiltration was significantly lower than after i.v. doses for the first three hours after administration (P <0.05).. We showed no differences in pain scores and analgesic consumption between local and i.v. administration of meloxicam 7.5 mg during the first 24 hr after herniorrhaphy, while plasma concentration of meloxicam was lower after local administration. These results indicate a lack of difference in pain relief after concentrating meloxicam at the hernia wound or after achieving high blood levels rapidly (i.v.). Local administration of meloxicam may confer an advantage over systemic administration by eliciting lower incidences of systemic adverse effects.

Topics: Administration, Topical; Adult; Aged; Analgesics, Non-Narcotic; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Hernia, Inguinal; Humans; Injections, Intravenous; Male; Meloxicam; Middle Aged; Pain, Postoperative; Thiazines; Thiazoles

We studied 36 patients, allocated randomly to receive meloxicam 15 mg rectally (n = 18) or placebo suppository (n = 18) before total abdominal hysterectomy in a double-blind study. Visual analogue scores for pain at rest (P < 0.005), on movement (P < 0.05) and on coughing (P < 0.05) were significantly decreased in the meloxicam group during the first 24 h after surgery. Mean 24-h PCA morphine requirements were 33.2 (SD 16.9) mg and 38.2 (20.8) mg in the meloxicam and placebo groups, respectively (ns). There was no difference in the incidence of nausea, vomiting or sedation between groups.

Topics: Adult; Aged; Analgesia, Patient-Controlled; Analgesics, Non-Narcotic; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Cyclooxygenase Inhibitors; Double-Blind Method; Drug Administration Schedule; Female; Humans; Hysterectomy; Meloxicam; Middle Aged; Morphine; Pain Measurement; Pain, Postoperative; Thiazines; Thiazoles

The adequacy of postoperative analgesia was assessed in 40 cats following ovariohysterectomy. At extubation, cats were given one dose of carprofen, ketoprofen, meloxicam or tolfenamic acid. Postoperative analgesia was assessed using visual analogue scale (VAS) scoring for pain and sedation; measurement of mechanical nociceptive thresholds at the wound; recognition of the requirement for rescue intervention analgesia; and an overall clinical assessment score at 18 hours. VAS pain scores were low throughout the trial, with no significant differences found between the groups. Postoperative mechanical nociceptive thresholds decreased significantly from baseline in all four groups, with no significant differences between the groups. One cat in each of the tolfenamic acid, ketoprofen and meloxicam groups required rescue intervention analgesia. Nine out of 10 cats in all four groups were classified as having desirable overall clinical assessment scores. In summary, all four drugs provided good postoperative analgesia, although none was able to prevent postoperative wound tenderness.

Topics: Analgesics; Animals; Anti-Inflammatory Agents, Non-Steroidal; Carbazoles; Cats; Female; Hysterectomy; Ketoprofen; Meloxicam; ortho-Aminobenzoates; Ovariectomy; Pain Measurement; Pain, Postoperative; Thiazines; Thiazoles; Treatment Outcome

A local anesthetic that provides analgesia lasting at least three days could significantly improve postoperative pain management. This study evaluated the analgesic efficacy and safety of an extended-release formulation of bupivacaine based on the injectable hydrogel carrier poly(N-isopropylacrylamide-co-dimethylbutyrolactone acrylamide-co-Jeffamine M-1000 acrylamide) (PNDJ).. The efficacy of PNDJ containing 4% bupivacaine (SBG004) given by peri-incisional subcutaneous injection (SBG004 SC) or wound filling instillation (SBG004 WF) was evaluated compared to saline, liposomal bupivacaine, bupivacaine collagen sponge, bupivacaine-meloxicam polyorthoester, and bupivacaine HCl in a porcine skin and muscle incision model. Mechanical allodynia was assessed by withdrawal from application of von Frey filaments, and local tolerance was evaluated by histology. Bupivacaine pharmacokinetics for SBG004 SC were measured in rabbits (16.5 mg bupivacaine/kg).. Animals demonstrated less mechanical allodynia at incisions receiving SBG004 SC for up to 96 hours postoperatively. Incisions treated with SBG004 SC tolerated more force without a withdrawal indicative of pain compared to saline for 96 hours, and compared to SBG004 WF and all active controls at 24, 48, and 72 hours except bupivacaine-meloxicam polyorthoester at 72 hours. By 49 days, SBG004 was histologically absent and was replaced with granulation tissue infiltrated with immune cells in some areas. In rabbits, Cmax was 41.6 ± 9.7 ng/mL with t1/2 82.0 ± 35.8 hours (mean ± SD).. Peri-incisional SBG004 SC provided extended release of bupivacaine sufficient to reduce sensation of incisional pain for 96 hours, in vivo bupivacaine delivery for at least 7 days, and a favorable local and systemic toxicity profile.

Topics: Acrylamides; Analgesia; Anesthetics, Local; Animals; Bupivacaine; Hydrogels; Hyperalgesia; Meloxicam; Pain, Postoperative; Rabbits; Temperature

Meloxicam is a nonsteroidal anti-inflammatory analgesic drug that is often used in mice. However, doses of 1 to 5 mg/kg given twice daily were recently reported to provide inadequate analgesia. Some studies suggest that doses of up to 20 mg/kg may be necessary for adequate pain management. We investigated the analgesia provided by a high-dose of meloxicam in female CD1 mice. Pharmacokinetic analyses demonstrated that a subcutaneous injection of 10 mg/kg or 20 mg/kg of meloxicam produced therapeutic plasma concentrations for at least 12 h. Ovariectomies via ventral laparotomy were performed to assess analgesic efficacy. Mice were treated immediately before surgery with a high-dose of 10 mg/kg, a low-dose of 2.5 mg/kg, or saline, followed by every 12 h for 36 h. At 3, 6, 12, 24, and 48 h after surgery, mice were assessed for pain based on the following behaviors: distance traveled, time mobile, grooming, rearing, hunched posture, orbital tightening, and von Frey. Initially, some mice received a 20-mg/kg loading dose followed by 10 mg/kg every 12 h. This regimen caused severe morbidity and mortality in 2 mice. Subsequently, this regimen was abandoned, and mice assigned to the high-dose group received 10 mg/kg every 12 h. Mice that received the 10-mg/kg dose after surgery showed less orbital tightening between 3 to 6 h and reduced frequency of hunched posture for 48 h compared with mice that received either the low-dose or saline. However, mice were significantly less mobile for 6 to 12 h after surgery regardless of treatment. These data indicate that a meloxicam dose of 10 mg/kg every 12 h provides better analgesia than a 2.5-mg/kg dose but does not completely alleviate pain.

Topics: Analgesia; Analgesics; Animals; Anti-Inflammatory Agents, Non-Steroidal; Female; Meloxicam; Mice; Pain; Pain Management; Pain, Postoperative; Thiazines

To assess the effectiveness of a multimodal analgesic regimen containing "safer" opioid and non-narcotic pain medications in decreasing opioid prescriptions after surgical fixation in orthopedic trauma.. Retrospective cohort study.. One urban, academic medical center.. Patients with traumatic fracture from 2018 (n=848) and 2019 (n=931).. In 2019, our orthopedic trauma division began a standardized protocol of postoperative pain medications that included 50 mg of tramadol four times daily, 15 mg of meloxicam once daily, 200 mg gabapentin twice daily, and 1 g of acetaminophen every 6 hours as needed. This multimodal regimen was dubbed the "Lopioid" protocol. We compared patients who received this protocol with all patients from the prior year who had followed a standard protocol that included Schedule II narcotics.. Greater mean morphine milligram equivalents were prescribed at discharge from fracture surgery under the standard protocol than under the Lopioid protocol (252.3 vs 150.0; P < 0.001), and there was a difference in the type of opioid medication prescribed (P < 0.001). There was a difference in the number of refills filled for patients discharged with opioids after surgical treatment between the standard and Lopioid cohorts (0.31 vs 0.21; P = 0.002). There were no differences in the types of medication-related complications (P = 0.710) or the need for formal pain management consults (P = 0.199), but patients in the Lopioid cohort had lower pain scores at discharge (2.2 vs 2.7; P = 0.001).. The Lopioid protocol was effective in decreasing the amount of Schedule II narcotics prescribed at discharge and the number of opioid refills after orthopedic surgery for fractures.

Topics: Acetaminophen; Analgesics; Analgesics, Opioid; Gabapentin; Humans; Meloxicam; Morphine Derivatives; Narcotics; Orthopedic Procedures; Pain, Postoperative; Prescriptions; Retrospective Studies; Tramadol

There is a need for postoperative pain control that minimizes or eliminates opioid use during the first 72 hours following surgery, when pain is most severe. HTX-011 is an extended-release, dual-acting local anesthetic that demonstrated superior 72-hour analgesia over standard of care bupivacaine hydrochloride (HCl) and saline placebo in a phase 3 bunionectomy study (EPOCH-1). Having shown HTX-011 monotherapy is superior to bupivacaine HCl in reducing postoperative pain intensity and opioid use, this follow-on study evaluated the safety and efficacy of HTX-011 as the foundation of a multimodal analgesia (MMA) regimen using over-the-counter medications recommended by practice guidelines for pain management.. Following regional anesthesia administered as a lidocaine block, patients underwent unilateral bunionectomy with osteotomy and internal fixation. Prior to closure, HTX-011 (up to 60 mg bupivacaine/1.8 mg meloxicam) was applied without a needle. Patients received scheduled postoperative MMA alternating ibuprofen (600 mg) and acetaminophen (1 g) every 3 hours for 72 hours. Efficacy was assessed based on pain intensity (numeric rating scale [NRS; 0-10]) and consumption of opioid rescue medication (intravenous morphine milligram equivalents [MME]). Adverse event and vital sign monitoring, plus laboratory and wound healing assessments, were used to determine safety.. Over the 72-hour assessment period following bunionectomy, mean pain scores were mild in severity (NRS <4) and 22/31 patients (71%) experienced no severe pain (NRS ≥7) with HTX-011 as the foundation of scheduled, non-opioid MMA. Patients consumed an average of 1.61 MME total, with 24/31 (77%) requiring no opioid rescue medication (opioid-free). HTX-011 was well-tolerated and demonstrated no safety concerns with the inclusion of postoperative MMA.. HTX-011 as the foundation of an MMA regimen including scheduled ibuprofen and acetaminophen maintained mean postoperative pain scores in the mild range and enabled opioid-free recovery for 77% of bunionectomy patients through the 28-day recovery period.

Topics: Analgesia; Analgesics, Non-Narcotic; Analgesics, Opioid; Anesthetics, Local; Bupivacaine; Double-Blind Method; Humans; Meloxicam; Pain, Postoperative

Topics: 4-Butyrolactone; Animals; Buprenorphine; Female; Hyperalgesia; Male; Meloxicam; Nociception; Pain, Postoperative; Rats; Rats, Sprague-Dawley; Sulfones

Topics: Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Bupivacaine; Humans; Meloxicam; Pain, Postoperative

In veterinary medicine, the administration of nonsteroidal anti-inflammatory analgesics (NSAIDs) for the control of postsurgical pain in dogs and cats is common given the anti-inflammatory, analgesic, and antipyretic effects of these drugs. This study compared the serum biochemical changes and postoperative analgesic effects of paracetamol, meloxicam, and carprofen in bitches submitted to an ovariohysterectomy using the Dynamic Interactive Visual Analog Scale (DIVAS) and Pain Scale of the University of Melbourne (UMPS) scoring systems.. Thirty bitches of different breeds underwent elective ovariohysterectomies and were randomly assigned to one of three treatment groups: a paracetamol group [15 mg kg-1 intravenous (IV)], a carprofen group (4 mg kg-1 IV), and a meloxicam group (0.2 mg kg-1 IV). All treatments were administered 30 minutes prior to surgery. Paracetamol was administered every 8 hours postoperatively for 48 hours total, while carprofen and meloxicam were intravenously administered every 24 hours. An evaluation of post-surgical pain was done with the DIVAS and the UMPS. The first post-surgical pain measurement was performed 1 hour after surgery and then 2, 4, 6, 8, 12, 16, 20, 24, 36, and 48 hours after surgery.. All groups exhibited a gradual reduction in pain throughout the postoperative period in both scales; however, neither scale significantly differed between the three treatment groups (P > 0.05) during the 48 postoperative hours.. Paracetamol was as effective as meloxicam and carprofen for post-surgical analgesia in bitches subjected to elective ovariohysterectomy. The present study demonstrates that paracetamol may be considered a tool for the effective treatment of acute perioperative pain in dogs. Furthermore, this drug led to no adverse reactions or changes in the parameters assessed in the present study, indicating its safety.

Topics: Acetaminophen; Analgesia; Animals; Anti-Inflammatory Agents, Non-Steroidal; Carbazoles; Cardiorespiratory Fitness; Dogs; Female; Hysterectomy; Kidney Function Tests; Liver Function Tests; Meloxicam; Ovariectomy; Pain, Postoperative

Effective postoperative analgesia may enhance early rehabilitation after total knee arthroplasty (TKA). The purpose of this study is to perform a randomized controlled trial to compare the efficiency of adductor canal block (ACB) with periarticular infiltration (PAI) versus PAI alone for early postoperative pain treatment after TKA.. After institutional review board approval, written informed consent was obtained from patients undergoing elective TKA. Subjects were randomized into 2 groups as follows: adductor canal blockade with 30 mL of 0.5% ropivacaine and 100 mcg of clonidine. All patients received a periarticular infiltration mixture intraoperatively with scheduled and patient requested oral and IV analgesics postoperatively for breakthrough pain. The primary outcome was morphine consumption in the first 24 hours. Secondary outcomes included pain scores, morphine consumption at 48 hours, opioid-related side effects (post-operative nausea/vomiting, sedation scores), functional outcomes, quadriceps strength, and length of hospital stay.. For the present trial, we hypothesized that patients receiving adductor canal block + PAI would have significantly lower morphine consumption and pain scores after surgery.. researchregistry5490.

Topics: Aged; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Arthroplasty, Replacement, Knee; Bupivacaine; Clinical Protocols; Famotidine; Female; Humans; Male; Meloxicam; Middle Aged; Nerve Block; Oxycodone; Pain Management; Pain, Postoperative; Pilot Projects

Most severe pain occurs within the first 72 hours after an operation, and current local anesthetics have a limited duration of action. HTX-011 is a dual-acting, local anesthetic containing bupivacaine, and low-dose meloxicam in an extended-release polymer. In a prior phase 3 inguinal herniorrhaphy study, HTX-011 alone provided superior pain relief for 72 hours and significantly decreased opioid use compared with saline placebo and bupivacaine hydrochloride. This open-label study assessed the safety, efficacy, and opioid-sparing properties of HTX-011 as the foundation of a scheduled, nonopioid, multimodal analgesia regimen in patients undergoing open inguinal herniorrhaphy.. This study was conducted in 2 sequential cohorts. All patients received a single, intraoperative dose of HTX-011 prior to wound closure, followed by a scheduled postoperative regimen of oral ibuprofen and acetaminophen for 72 hours. Patients in cohort 2 also received a single intraoperative dose of ketorolac. Opioid analgesics were available by request only.. More than 90% of patients remained opioid-free through 72 hours postoperatively, and 83% of patients remained opioid-free through day 28 (last study visit). Pain was well controlled, and mean intensity of the pain never increased higher than the mild range during the first 72 hours. Ketorolac did not demonstrate any additional benefit. HTX-011 with this multimodal analgesia regimen was well tolerated.. HTX-011 when used as the foundation of a nonopioid, multimodal analgesia regimen, provided effective and well-tolerated analgesia without the need for opioids in the majority of patients recovering from an open inguinal herniorrhaphy.

Topics: Adult; Aged; Analgesics, Opioid; Anesthetics, Local; Bupivacaine; Female; Hernia, Inguinal; Herniorrhaphy; Humans; Male; Meloxicam; Middle Aged; Pain, Postoperative

The aim of this network meta-analysis (NMA) was to evaluate the safety and efficacy of intravenous (IV) Meloxicam 30 mg (MIV), an investigational non-steroidal anti-inflammatory drug (NSAID), and certain other IV non-opioid analgesics for moderate-severe acute postoperative pain.. We searched PubMed and CENTRAL for Randomized Controlled Trials (RCT) (years 2000-2019, adult human subjects) of IV non-opioid analgesics (IV NSAIDs or IV Acetaminophen) used to treat acute pain after abdominal, hysterectomy, bunionectomy or orthopedic procedures. A Bayesian NMA was conducted in R to rank treatments based on the standardized mean differences in sum of pain intensity difference from baseline up to 24 h postoperatively (sum of pain intensity difference: SPID 24). The probability and the cumulative probability of rank for each treatment were calculated, and the surface under the cumulative ranking curve (SUCRA) was applied to distinguish treatments on the basis of their outcomes such that higher SUCRA values indicate better outcomes. The study protocol was prospectively registered with by PROSPERO (CRD42019117360).. Out of 2313 screened studies, 27 studies with 36 comparative observations were included, producing a treatment network that included the four non-opioid IV pain medications of interest (MIV, ketorolac, acetaminophen, and ibuprofen). MIV was associated with the largest SPID 24 for all procedure categories and comparators. The SUCRA ranking table indicated that MIV had the highest probability for the most effective treatment for abdominal (89.5%), bunionectomy (100%), and hysterectomy (99.8%). MIV was associated with significantly less MME utilization versus all comparators for abdominal procedures, hysterectomy, and versus acetaminophen in orthopedic procedures. Elsewhere MME utilization outcomes for MIV were largely equivalent or nominally better than other comparators. Odds of ORADEs were significantly higher for all comparators vs MIV for orthopedic (gastrointestinal) and hysterectomy (respiratory).. MIV 30 mg may provide better pain reduction with similar or better safety compared to other approved IV non-opioid analgesics. Caution is warranted in interpreting these results as all comparisons involving MIV were indirect.

Topics: Analgesics, Non-Narcotic; Humans; Meloxicam; Network Meta-Analysis; Pain, Postoperative; Randomized Controlled Trials as Topic

There is a growing interest in the use of voluntarily displayed ongoing behaviours in laboratory animals to assess the pain experience. In rats, two behavioural pain scales, the Rat Grimace Scale (RGS, a facial expression scale) and a composite behaviour score (CBS, a behavioural ethogram reliant on postural changes), are both promising pain assessment methods. Both scales have been used to assess pain in a laparotomy model, however, they have never been compared directly and the knowledge of how different analgesics may affect these two scales is limited. This study aimed to provide a comparison to discriminate the temporal and analgesic response in a laparotomy model. Female Wistar (n = 26) and Sprague Dawley rats (n = 26) were block randomized to receive saline, meloxicam (2 mg/kg) or buprenorphine (0.05 mg/kg) 30 minutes before laparotomy. Rats were video-recorded before surgery (BL) and at 30, 150, 270, and 390 minutes post-operatively. Videos were assessed according to both scales by a trained, blinded observer. Both CBS and RGS scores increased significantly at all post surgical timepoints in the saline group. Both buprenorphine and meloxicam reduced CBS scores to baseline levels following laparotomy; however, RGS scores were only reduced following buprenorphine. RGS scores in the meloxicam group remained similar to scores of the saline group. These findings suggest that the CBS and RGS differ in their sensitivity to discriminating analgesic effects.

Topics: Animals; Buprenorphine; Facial Expression; Female; Laparotomy; Meloxicam; Pain Measurement; Pain, Postoperative; Posture; Rats; Rats, Sprague-Dawley; Rats, Wistar

NSAIDs are often used in horses with colic syndrome during the postoperative period, due to their ability to contrast endotoxemia and to promote an analgesic and anti-inflammatory effect. As the pharmacokinetics of a drug are often modified in unhealthy animals compared to healthy subjects, the aim of this study was to evaluate the pharmacokinetic profile of meloxicam after i.v. administration in horses undergoing laparotomy for colic syndrome. Eight horses received 0.6 mg/kg of meloxicam i.v. towards the end of surgery. Blood samples were taken at scheduled time points during the following 24 hr. The serum concentration of the drug was determined by HPLC. Terminal half-life (6.88 ± 2.96 hr), volume of distribution at steady-state (186.53 ± 61.20 ml/Kg) and clearance (27.91 ± 5.72 ml kg

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Area Under Curve; Colic; Female; Half-Life; Horse Diseases; Horses; Male; Meloxicam; Pain, Postoperative; Thiazines; Thiazoles

To assess the effects of a topical anaesthetic (TA) and buccal meloxicam (BM) on behaviour, maximum wound temperature and wound morphology following amputation dehorning of beef calves, 50 unweaned Hereford calves were randomly allocated to: (1) sham dehorning / control (CON, n = 14); (2) amputation dehorning (D, n = 12); (3) amputation dehorning with pre-operative buccal meloxicam (DBM, n = 12); and (4) amputation dehorning with post-operative topical anaesthetic (DTA, n = 12). Videos of the calves were captured for 3 h following treatment. Each calf was later observed for 5 min every hour and the frequency and duration of specific behaviours displayed during these focal periods was recorded. Infrared and digital photographs of dehorning wounds were collected from all dehorned calves on days 1, 3 and 7 following treatment. Infrared photographs were used to identify the maximum temperature within the wound area. Digital photographs were used to score wounds based on visual signs of inflammation and healing, using a numerical rating scale of 1 to 3, with morphological aspects of inflammation increasing and morphological aspects of healing decreasing with progressive scores. CON calves displayed fewer head shakes than all dehorned calves at 2 and 3 h following treatment (P = 0.025). CON and DTA calves displayed less head turns than DBM calves at 2 h following treatment (P = 0.036). CON calves displayed fewer combined point behaviours than all dehorned calves at 2 h following treatment (P = 0.037). All dehorning wounds had a greater maximum temperature on days 3 and 7 compared to day 1 (P = 0.003). All wound morphology scores decreased from day 1 to day 3 and wound morphology scores of DBM and DTA calves increased from day 3 to day 7 (P = 0.03). Although flystrike may have confounded these observations, no clear effects of TA or BM on behaviour, maximum wound temperature or wound morphology following dehorning of calves were observed. Further research is required to evaluate the analgesic efficacy of these products for amputation dehorning of calves.

Topics: Administration, Topical; Anesthetics, Local; Animals; Anti-Inflammatory Agents, Non-Steroidal; Behavior, Animal; Body Temperature; Cattle; Horns; Inflammation; Male; Meloxicam; Pain Management; Pain, Postoperative

To assess the effect of meloxicam and lidocaine on indicators of pain associated with castration, forty-eight Angus crossbred beef calves (304 ± 40.5 kg of BW, 7-8 months of age) were used in a 28 day experiment. The experiment consisted of a 2 × 2 factorial design where main factors included provision of analgesia and local anaesthesia. Analgesia consisted of: no-meloxicam (N; n = 24) single s.c. administration of lactated ringer's solution and meloxicam (M; n = 24) single dose of 0.5 mg/kg of s.c. meloxicam. Local anesthesia consisted of: no-lidocaine (R; n = 24) ring block administration of lactated ringer's solution or lidociane (L; n = 24) ring block administration of lidocaine. To yield the following treatments: no meloxicam + no lidocaine (N-R; n = 12), no meloxicam + lidocaine (N-L; n = 12), meloxicam + no lidocaine (M-R; n = 12) and meloxicam + lidocaine (M-L; n = 12). Salivary cortisol concentrations were lower (lidocaine × time effect; P < 0.01) in L calves than R calves 0.5 and 1 hours after castration, while concentrations were lower (meloxicam × time effect; P = 0.02) in M calves than N calves at 2, 4 and 48 hours. The serum amyloid-A concentrations were greater (lidocaine × time effect; P < 0.01) in R calves than L calves on days 1, 3, 21 and 28 after castration. Haptoglobin concentrations were greater (meloxicam × time effect; P = 0.01) in N calves than M calves 24 and 48 hours after castration. Lower (lidocaine effect; P < 0.01) visual analog scale (VAS) scores, leg movement frequencies and head movement distance were observed in L calves than R calves at the time of castration. Escape behaviour during castration was lower (lidocaine effect; P < 0.05) in L calves than R calves based on data captured with accelerometer and head gate devices. Scrotal circumference had a triple interaction (lidocaine × meloxicam × time; P = 0.03), where M-R calves had greater scrotal circumference than M-L calves 28 d after castration, but no differences were observed between both groups and N-R and N-L calves. No differences (P > 0.05) were observed for average daily gain (ADG), weights or feeding behaviour. Overall, both lidocaine and meloxicam reduced physiological and behavioural indicators of pain. Although there was only one meloxicam × lidocaine interaction, lidocaine and meloxicam reduced physiological and behavioural parameters at different time points, which could be more effective at mitigating pain than either drug on its own.

Topics: Anesthesia, Local; Animals; Castration; Cattle; Lidocaine; Male; Meloxicam; Pain, Postoperative; Scrotum; Serum Amyloid A Protein; Time Factors

The objectives of this study were to describe the routine use of analgesics by Ontario veterinarians for common surgeries in dogs and cats, and to compare routine use of analgesics between species and surgeries, using Chi-square analyses. In total, 239 veterinarians responded to the questionnaires; a response rate of 13.1%. Fifty-two percent to 79% of veterinarians used meloxicam for both species and all surgeries. Approximately 9% of veterinarians did not use analgesics for dog ovariohysterectomy and castration, while 16% to 22% did not use analgesics for these surgeries in cats. Veterinarians used and dispensed analgesics to dogs more often than to cats (

Topics: Analgesics; Animals; Anti-Inflammatory Agents, Non-Steroidal; Castration; Cats; Dogs; Female; Hysterectomy; Male; Meloxicam; Ontario; Ovariectomy; Pain; Pain, Postoperative; Surveys and Questionnaires; Thiazines; Thiazoles; Veterinarians

To evaluate the effects of demeanor on validated pain assessment scales.. Prospective, blind, clinical trial.. Thirty three adult domestic cats scheduled for orchiectomy.. Cats were assessed for pain pre (baseline) and 1, 2, 4 hours postoperatively using two validated pain scales [Composite Measures Pain Scale-Feline (rCMPS-F) and UNESP-Botucatu multidimensional composite pain scale (psychomotor and pain expression subscales; U-B MCPS-psych and -painex)], and a demeanor scale. Return of sternal recumbency and postoperative feeding were recorded. Anesthesia consisted of a single intramuscular injection of dexmedetomidine-ketamine-hydromorphone with intratesticular lidocaine and atipamezole and meloxicam postoperatively. Following data collection, cats were assigned to two groups based on baseline demeanor scores (LO ≤ 5/21, 18 cats; HI ≥ 6/21, 15 cats) and data from each group compared.. Baseline demeanor predicted pain scores with the U-B MCPS-psych scale: baseline [LO 0 (0-0), HI 2 (0-6), p = 0.0005], 1 hour [LO 1 (0-5), HI 3 (1-5), p = 0.02], and 4 hours [LO 0 (0-2), HI 1 (0-6), p = 0.01]. A similar pattern was observed with the rCMPS-F. This resulted in more crossings of the analgesic intervention threshold in the HI group: U-B UNESP-psych (9 versus 1, p = 0.005) and rCMPS-F (23 versus 3, p < 0.0001). In contrast, U-B MCPS-painex scores did not differ between LO/HI groups: baseline (p > 0.99), 1 hour (p = 0.34), 2 hours (p > 0.99) and 4 hours (p = 0.31). LO cats ate sooner (61% versus 33% by 1 hour, p < 0.0001) despite similar times to sternal recumbency (p = 0.48).. Demeanor affected pain assessment with U-B UNESP-psych and rCMPS-F scales, but not U-B UNESP-painex scale. Demeanor had a significant effect on postoperative feeding. These data highlight the potential for demeanor to confound pain assessment.

Topics: Anesthesia; Animals; Cats; Dexmedetomidine; Hydromorphone; Imidazoles; Ketamine; Lidocaine; Male; Meloxicam; Orchiectomy; Pain Measurement; Pain, Postoperative; Perioperative Period; Prospective Studies; Thiazines; Thiazoles

Inflammation is thought to be a major contributor to post-surgical pain, so non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used analgesics. However, compared to rats, considerably less is known as to how successfully these prevent pain in mice.. A fluorescent COX-2 selective probe was used for the first time to evaluate the post-surgical anti-inflammatory effects of meloxicam, and automated behaviour analyses (HomeCageScan; HCS), the Mouse Grimace Scale (MGS) and body weight changes to assess its pain-preventative properties. Groups of 8-9 BALB/c mice were subcutaneously injected with saline (0.3 mL) or meloxicam at (1, 5 or 20 mg/kg) 1 h before a 1.5-cm midline laparotomy. The probe or a control dye (2 mg/kg) was injected intravenously 3 h later. Imaging was used to quantify inflammation at 7, 24 and 48 h following surgery. HCS data and MGS scores were respectively obtained from video recordings and photographs before surgery and 24 h later.. Post-surgical inflammation was dose dependently reduced by meloxicam; with 5 or 20 mg/kg being most effective compared to saline. However, all mice lost weight, MGS scores increased and behavioural activity was reduced by surgery for at least 24 h with no perceivable beneficial effect of meloxicam on any of these potentially pain-associated changes.. Although meloxicam prevented inflammation, even large doses did not prevent post-laparotomy pain possibly arising due to a range of factors, including, but not limited to inflammation. MGS scoring can be applied by very naïve assessors and so should be effective for cage-side use.

Topics: Analgesics; Animals; Anti-Inflammatory Agents, Non-Steroidal; Inflammation; Laparotomy; Male; Meloxicam; Mice; Pain Measurement; Pain, Postoperative; Thiazines; Thiazoles

Cervicobrachial pain (CBP) is often resistant to conventional oral analgesics. We hypothesized that the periradicular injection of meloxicam would produce a significant reduction in their intractable CBP. The secondary objective was to assess the impact of the treatment on functional recovery.. 48 patients with persistent CBP (>3 months of duration) despite multimodal analgesic therapy received 1-3 periradicular injections of meloxicam, 5-20 mg, at the dermatomal level(s) corresponding to their pain symptoms. Pain level (0=none to 10=severe), rescue analgesics, and functional activity were recorded at baseline and for 90d after the last injection. The injection was repeated if the pain score remained >3 or paresthesia persisted.. The mean pain score was reduced from a baseline of 8.9 (±1) to 1.7 (±2.2) at 90 days after the last meloxicam injection. Following meloxicam treatment(s), only 13% of the patients required oral analgesic rescue medication. All patients increased their functional activity level.. Cervical periradicular injection of meloxicam reduced CBP by 81% at 90-day follow-up and also improved functional recovery.

Topics: Adult; Aged; Aged, 80 and over; Analgesics; Anti-Inflammatory Agents, Non-Steroidal; Brachial Plexus Neuritis; Chronic Pain; Female; Humans; Male; Meloxicam; Middle Aged; Pain, Postoperative; Recovery of Function; Thiazines; Thiazoles

Methods to reduce castration-related pain in piglets are still issues of concern and interest for authorities and producers. Our objectives were to estimate the effectiveness of two protocols of local anesthesia (lidocaine and the combination of lidocaine+bupivacaine) as well as the use of meloxicam as a postoperative analgesic in alleviating castration-related pain, measured by acute physiological responses. Eight groups (15 piglets/group) were included in the study: (1) castration without anesthesia or analgesia, without meloxicam (TRAD WITHOUT), (2) castration without anesthesia or analgesia, but with meloxicam (TRAD WITH), (3) handling without meloxicam (SHAM WITHOUT), (4) handling with meloxicam (SHAM WITH), (5) castration after local anesthesia with lidocaine but without meloxicam (LIDO WITHOUT), (6) castration after local anesthesia with lidocaine and meloxicam (LIDO WITH), (7) castration after local anesthesia with lidocaine+bupivacaine without meloxicam (LIDO+BUPI WITHOUT), (8) castration after local anesthesia with lidocaine+bupivacaine and meloxicam (LIDO+BUPI WITH). Acute physiological responses measured included skin surface temperature and serum glucose and cortisol concentrations. On days 4 and 11 post-castration BW was recorded and average daily gain was calculated over this period. Furthermore, piglet mortality was recorded over the 11-day post-castration period. Administration of local anesthetic or meloxicam did not prevent the decrease in skin surface temperature associated with castration. Lidocaine reduced the increase in glucose concentration associated with castration. For castrated pigs, the joint use of lidocaine and meloxicam caused a significant decrease in cortisol concentration; the combination of intratesticular lidocaine and bupivacaine did not seem to be more effective than lidocaine alone. No effect of treatments on mortality and growth were detected.

Topics: Analgesics; Anesthesia, Local; Anesthetics, Local; Animals; Male; Meloxicam; Orchiectomy; Pain, Postoperative; Sus scrofa; Thiazines; Thiazoles

Postoperative analgesia in laboratory rats is complicated by the frequent handling associated with common analgesic dosing requirements. Here, we evaluated sustained-release buprenorphine (Bup-SR), sustained-release meloxicam (Melox-SR), and carprofen gel (CG) as refinements for postoperative analgesia. The aim of this study was to investigate whether postoperative administration of Bup-SR, Melox-SR, or CG effectively controls behavioral mechanical and thermal hypersensitivity in a rat model of incisional pain. Rats were randomly assigned to 1 of 5 treatment groups: saline, 1 mL/kg SC BID; buprenorphine HCl (Bup HCl), 0.05 mg/kg SC BID; Bup-SR, 1.2 mg/kg SC once; Melox-SR, 4 mg/kg SC once; and CG, 2 oz PO daily. Mechanical and thermal hypersensitivity were tested daily from day-1 through 4. Bup HCl and Bup-SR attenuated mechanical and thermal hypersensitivity on days 1 through 4. Melox-SR and CG attenuated mechanical hypersensitivity-but not thermal hypersensitivity-on days 1 through 4. Plasma concentrations, measured by using UPLC with mass spectrometry, were consistent between both buprenorphine formulations. Gross pathologic examination revealed no signs of toxicity in any group. These findings suggest that postoperative administration of Bup HCl and Bup-SR-but not Melox-SR or CG-effectively attenuates mechanical and thermal hypersensitivity in a rat model of incisional pain.

Topics: Analgesics; Animals; Body Weight; Buprenorphine; Carbazoles; Delayed-Action Preparations; Male; Meloxicam; Pain, Postoperative; Random Allocation; Rats; Rats, Sprague-Dawley; Thiazines; Thiazoles

Castration is one of the most common procedures performed on beef and dairy cattle. The objective of the study was to determine the efficacy of meloxicam oral suspension in reducing pain and inflammation in calves following band or surgical castration.. Two identical trials with the exception of the method of castration (Band Castration Study 1 and Surgical Castration Study 2) were conducted. Sixty (60) healthy Holstein calves 4 to 5 months of age (138-202 Kg) were used. Animals received either Meloxicam Oral Suspension at a dose of 1 mg/kg BW (n = 15 Study 1 and 15 Study 2) or Saline (n = 15 Study 1 and 15 Study 2) 2 h before castration. Physiological (Heart Rate, Plasma Cortisol and Plasma Substance P) and Behavioral (Visual Analog Scale (VAS), Accelerometers and tail Pedometers) evaluations were conducted before (day -1) and after Castration (Day 0, 1, 2, 3). Inflammation was evaluated daily by providing an individual animal score (Study1) or with a measurement of scrotal thickness (Study 2).. Heart rates were significantly greater in control animals following band and surgical castration. Plasma cortisol and substance P were significantly reduced in animals receiving Meloxicam Oral Suspension. Control animals had significantly greater VAS scores. Accelerometers showed that meloxicam treated animals had a significantly greater motion index and number of steps as well as less % time lying and number of lying bouts. The scrotal inflammation (based on scrotal swelling) was significantly decreased in the meloxicam treated animals compared to the control animals on day 1, day 2 and 3.. Meloxicam Oral Suspension was able to significantly reduce the display of painful behaviors and physiological responses to pain in band castrated and surgical castrated calves for up to 72 h following a single oral treatment of 1 mg/kg body weight. Meloxicam Oral Suspension was able to significantly reduce scrotal inflammation in band castrated and surgical castrated calves.

Topics: Administration, Oral; Animals; Anti-Inflammatory Agents, Non-Steroidal; Cattle; Heart Rate; Hydrocortisone; Inflammation; Male; Meloxicam; Orchiectomy; Pain Measurement; Pain, Postoperative; Substance P; Thiazines; Thiazoles

The goal of the current study was to compare the efficacy, adverse effects, and plasma buprenorphine concentrations of sustained-release buprenorphine (SRB) and buprenorphine after subcutaneous administration in dogs undergoing ovariohysterectomy. In a prospective, randomized, blinded design, 20 healthy adult female Beagle dogs underwent routine ovariohysterectomy and received multimodal analgesia consisting of meloxicam and one of two buprenorphine formulations. Dogs were randomly assigned to receive either SRB (0.2 mg/kg SC, once) or buprenorphine (0.02 mg/kg SC every 12 h for 3 d). Blinded observers assessed all dogs by using sedation scores, pain scores, temperature, HR, RR, and general wellbeing. Dogs were provided rescue analgesia with 0.02 mg/kg buprenorphine SC if the postoperative pain score exceeded a prede- termined threshold. Blood samples were collected, and mass spectrometry was used to determine plasma buprenorphine concentrations. Data were analyzed with a linear mixed model and Tukey-Kramer multiple comparison. Age, body weight, anesthetic duration, surgical duration, sevoflurane concentration, and cardiorespiratory variables did not differ significantly between groups. Dogs in both formulation groups had comparable postoperative sedation and pain scores. One dog from each formulation group had breakthrough pain requiring rescue analgesia. Plasma buprenorphine concentrations remained above a hypothesized therapeutic concentration of 0.6 ng/mL for 136.0 ± 11.3 and 10.67 ± 0.84 h for SRB and buprenorphine, respectively. Based on the results of this study, multimodal analgesic regimens consisting of meloxicam and either buprenorphine or SRB are equally efficacious in managing pain associated with an ovariohysterectomy and show comparable side effects.

Topics: Analgesics; Animals; Buprenorphine; Cytokines; Delayed-Action Preparations; Dogs; Female; Humans; Hysterectomy; Meloxicam; Ovariectomy; Pain Measurement; Pain, Postoperative; Prospective Studies; Thiazines; Thiazoles; Veins

To investigate a novel route for providing analgesia to processed piglets via transmammary drug delivery, meloxicam was administered orally to sows after farrowing. The objectives of the study were to demonstrate meloxicam transfer from sows to piglets via milk and to describe the analgesic effects in piglets after processing through assessment of pain biomarkers and infrared thermography (IRT). Ten sows received either meloxicam (30 mg/kg) (n = 5) or whey protein (placebo) (n = 5) in their daily feedings, starting four days after farrowing and continuing for three consecutive days. During this period, blood and milk samples were collected at 12-hour intervals. On Day 5 after farrowing, three boars and three gilts from each litter were castrated or sham castrated, tail docked, and administered an iron injection. Piglet blood samples were collected immediately before processing and at predetermined times over an 84-hour period. IRT images were captured at each piglet blood collection point. Plasma was tested to confirm meloxicam concentrations using a validated high-performance liquid chromatography-mass spectrometry method. Meloxicam was detected in all piglets nursing on medicated sows at each time point, and the mean (± standard error of the mean) meloxicam concentration at castration was 568.9±105.8 ng/mL. Furthermore, ex-vivo prostaglandin E2 (PGE2) synthesis inhibition was greater in piglets from treated sows compared to controls (p = 0.0059). There was a time-by-treatment interaction for plasma cortisol (p = 0.0009), with meloxicam-treated piglets demonstrating lower cortisol concentrations than control piglets for 10 hours after castration. No differences in mean plasma substance P concentrations between treatment groups were observed (p = 0.67). Lower cranial skin temperatures on IRT were observed in placebo compared to meloxicam-treated piglets (p = 0.015). This study demonstrates the successful transfer of meloxicam from sows to piglets through milk and corresponding analgesia after processing, as evidenced by a decrease in cortisol and PGE2 levels and maintenance of cranial skin temperature.

Topics: Animals; Animals, Newborn; Anti-Inflammatory Agents, Non-Steroidal; Castration; Dinoprostone; Meloxicam; Pain, Postoperative; Swine; Thiazines; Thiazoles

Despite the increasing use of rabbits as companion animals and models for biomedical research, rabbits have not been extensively studied to identify an efficacious postsurgical analgesic that does not cause systemic complications. The synergy of NSAID and systemic opioids is well-documented, and their combined use reduces the amount of either drug required for adequate analgesia. We measured fecal corticosterone metabolites (FCM) in rabbits after a minimally invasive vascular cut-down procedure. Rabbits received buprenorphine (0.03 mg/kg SC every 12 h for 3 d), meloxicam (0.2 mg/kg SC every 24 h for 3 d), buprenorphine-meloxicam (0.01 mg/kg-0.1 mg/kg SC every 24 h for 3 d), or a single dose of 0.5% bupivacaine (0.5 mL) infused locally at the incision site. By day 3 after surgery, buprenorphine, meloxicam, and bupivacaine groups showed elevated FCM levels, which continued to rise until day 7 and then gradually returned to baseline by day 28. In the buprenorphine-meloxicam group, FCM was relatively unchanged until day 3, when treatment was discontinued, and then began to rise. Rabbits in the buprenorphine-meloxicam group gained more weight over the 28-d study than did those in the other 3 treatment groups. This study shows that in rabbits low-dose buprenorphine administered with meloxicam effectively mitigates the FCM response that develops after surgery without the adverse effects associated with higher doses.

Topics: Analgesia; Analgesics, Opioid; Anesthetics, Local; Animals; Anti-Inflammatory Agents, Non-Steroidal; Body Weight; Bupivacaine; Buprenorphine; Corticosterone; Drug Therapy, Combination; Feces; Glucocorticoids; Male; Meloxicam; Minimally Invasive Surgical Procedures; Pain, Postoperative; Rabbits; Thiazines; Thiazoles

To validate a model of postfracture pain in perching birds.. 21 adult domestic pigeons (Columba livia).. In each bird, a standardized osteotomy of 1 femur was performed and the fracture was immobilized with an intramedullary pin. Degree of postoperative pain was evaluated 6 times/d for 4 days by use of 3 methods: an electronic perch for assessment of weight-bearing load differential of the pelvic limbs, 4 numeric rating pain scales for assessment of pain (all of which involved the observer in the same room as the bird), and analysis of video-recorded (observer absent) partial ethograms for bird activity and posture. Measurements obtained were compared with data collected before the surgery to evaluate the ability of these methods to detect pain.. The weight-bearing load differential was a sensitive, specific, reliable, and indirect measure of fracture-associated pain in the model used. Two of 4 tested pain scales (fractured limb position and subjective evaluation of degree of pain) were sensitive and specific for detecting pain and were reliable in a research setting. Interobserver reliability of the 4 pain scales was excellent. Partial ethograms were sensitive for identifying pain-associated behavior in pigeons, particularly during the first 2 days after surgery.. The fracture pain model was reliable and reproducible and may be useful for experimental studies involving postsurgical pain in pigeons. Weight-bearing load differential was the most sensitive and specific means of determining degree of pain in pigeons during the first 4 days after hind limb fracture induction.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Bird Diseases; Bone Diseases; Columbidae; Femoral Fractures; Male; Meloxicam; Osteotomy; Pain Measurement; Pain, Postoperative; Reproducibility of Results; Thiazines; Thiazoles; Weight-Bearing

Current behaviour-based pain assessments for laboratory rodents have significant limitations. Assessment of facial expression changes, as a novel means of pain scoring, may overcome some of these limitations. The Mouse Grimace Scale appears to offer a means of assessing post-operative pain in mice that is as effective as manual behavioural-based scoring, without the limitations of such schemes. Effective assessment of post-operative pain is not only critical for animal welfare, but also the validity of science using animal models.. This study compared changes in behaviour assessed using both an automated system ("HomeCageScan") and using manual analysis with changes in facial expressions assessed using the Mouse Grimace Scale (MGS). Mice (n = 6/group) were assessed before and after surgery (scrotal approach vasectomy) and either received saline, meloxicam or bupivacaine. Both the MGS and manual scoring of pain behaviours identified clear differences between the pre and post surgery periods and between those animals receiving analgesia (20 mg/kg meloxicam or 5 mg/kg bupivacaine) or saline post-operatively. Both of these assessments were highly correlated with those showing high MGS scores also exhibiting high frequencies of pain behaviours. Automated behavioural analysis in contrast was only able to detect differences between the pre and post surgery periods.. In conclusion, both the Mouse Grimace Scale and manual scoring of pain behaviours are assessing the presence of post-surgical pain, whereas automated behavioural analysis could be detecting surgical stress and/or post-surgical pain. This study suggests that the Mouse Grimace Scale could prove to be a quick and easy means of assessing post-surgical pain, and the efficacy of analgesic treatment in mice that overcomes some of the limitations of behaviour-based assessment schemes.

Topics: Analgesia; Analgesics; Animals; Behavior, Animal; Bupivacaine; Facial Expression; Humans; Male; Meloxicam; Mice; Models, Animal; Pain Measurement; Pain, Postoperative; Postoperative Period; Research Design; Sodium Chloride; Thiazines; Thiazoles; Vasectomy

Three- or 5-day courses of meloxicam [0.2 mg/kg body weight (BW) subcutaneously pre- or postoperatively on Day 1 followed by 0.05 mg/kg BW, PO per day thereafter] were assessed for analgesic efficacy and safety in 50 client-owned cats undergoing onychectomy and sterilization. Primary outcome parameters were analgesia score, gait/lameness score, and need for rescue analgesia assessed at times 0, 1, 4, 7, 24, 28, 35, 48, 52, 57 hours and on Day 5. Packed cell volume/total solids and serum biochemistry were assessed at time 0 and Days 3 and 5. There were no differences in efficacy and safety parameters regardless of the treatment protocol employed and no cat required rescue analgesia. The patients that received meloxicam preoperatively had statistically better gait/lameness scores than those that received meloxicam postoperatively, supporting the principle of preemptive analgesia.

Topics: Analgesics; Animals; Anti-Inflammatory Agents, Non-Steroidal; Cats; Female; Hysterectomy; Male; Meloxicam; Orchiectomy; Ovariectomy; Pain Measurement; Pain, Postoperative; Thiazines; Thiazoles; Time Factors; Treatment Outcome

The dynamics of Parecoxib or Meloxicam analgesic effect on acute postoperative pain was studied in 48 patients (22 female and 26 male) sustaining arthroprosthetic (Parecoxib analgesia) or arthroscopic (Meloxicam analgesia) orthopedic surgery. The results show higher postoperative pain and slower dynamics of Parecoxib and Meloxicam analgesia in women than in men, which necessitates supplementation of the applied analgesic medication in the female patients.

Topics: Adolescent; Adult; Aged; Analgesia; Analgesics; Cyclooxygenase 2 Inhibitors; Female; Humans; Isoxazoles; Male; Meloxicam; Middle Aged; Orthopedic Procedures; Pain, Postoperative; Thiazines; Thiazoles; Young Adult

Topics: Anti-Inflammatory Agents, Non-Steroidal; Cyclooxygenase Inhibitors; Edema; Humans; Meloxicam; Molar, Third; Pain, Postoperative; Sulfonamides; Thiazines; Thiazoles; Tooth Extraction; Tooth, Impacted; Trismus

C57BL/6NCrl male mice (n = 60; age, 6 to 7 wk) underwent partial hepatectomy or no surgery and were given 1 of 3 analgesics pre- and postoperatively. Food and water consumption, body weight, running wheel activity, locomotor activity, and serum corticosterone concentrations were measured before and after surgery. Mice that were surgically manipulated weighed significantly less on days 1 through 3 after surgery than did mice not manipulated surgically. On the day of surgery, the surgery groups consumed significantly less feed (-1.5±0.35 g) than did nonsurgery groups. There were no differences in water consumption on any day between surgery and nonsurgery groups or among the 3 analgesic groups. For running wheel activity, significant decreases in the surgery groups were seen at day 1 after surgery compared with baseline. Surgery groups that received buprenorphine and meloxicam returned to baseline activity levels on day 2 after surgery. Open-field testing revealed no significant differences in locomotor activity in any groups; however, posttreatment locomotor activity in the buprenorphine nonsurgery group was increased compared with baseline, and posttreatment locomotor activity in the flunixin meglumine surgery group was decreased compared with baseline. Serum corticosterone concentrations were within normal limits regardless of treatment in all groups. Comparison of the overall results indicated that meloxicam and buprenorphine, at the dose given, appear to be suitable postoperative analgesics for partial hepatectomy in mice. Flunixin meglumine at the given dosage (2.5 mg/kg) may not provide adequate analgesia for partial hepatectomy.

Topics: Analgesics, Opioid; Animals; Anti-Inflammatory Agents, Non-Steroidal; Behavior, Animal; Buprenorphine; Clonixin; Drinking; Eating; Hepatectomy; Male; Meloxicam; Mice; Mice, Inbred C57BL; Models, Animal; Pain, Postoperative; Postoperative Period; Thiazines; Thiazoles

To investigate the effect of preoperative meloxicam administration on postoperative stress and pain induced by surgical castration in piglets.. Prospective, blinded, randomized clinical trial.. One hundred and eighty male piglets of <1 week of age.. Castration was performed on 150 piglets which had received either an intramuscular injection of 0.4 mg kg(-1) meloxicam or a placebo 10-30 minutes before the procedure. Blood cortisol and ACTH concentrations were determined at 30 minutes post-castration and haptoglobin was measured at 24 hours post-castration. Presence or absence of foreleg movements, hind leg movements, urine or faeces emission, tremors or other body movements were recorded during the castration procedure. Scores for presence or absence of prostration, tremors, tail movements and isolation were recorded at 30 minutes, and at 1, 2, 4 and 24 hours post-castration and combined in a global behaviour score (GBS). Blood samples were taken from a further 30 piglets which did not undergo castration.. Mean blood cortisol and ACTH concentrations at 30 minutes post-castration were both significantly lower in the meloxicam group than in the placebo group (p < or = 0.01). The mean haptoglobin concentration at 24 hours was not significantly reduced (p = 0.178). The distribution of the GBS during castration was similar in both groups. There were significant differences in the GBS after castration at both 2 and 4 hours post-castration with a greater proportion of piglets in the meloxicam group showing no behavioural alterations (82.7%versus 68.0% at both time points). The score distribution was similar in both groups at 30 minutes, 1 and 24 hours after castration.. This study suggests that pre-emptive administration of meloxicam is able to produce some postoperative analgesia after surgical castration of young piglets.

Topics: Adrenocorticotropic Hormone; Analgesia; Animals; Anti-Inflammatory Agents, Non-Steroidal; Haptoglobins; Hydrocortisone; Male; Meloxicam; Orchiectomy; Pain Measurement; Pain, Postoperative; Thiazines; Thiazoles; Time Factors

Buprenorphine is administered to humans and animals for postoperative pain management, although its use is associated with complications. Alternative analgesics, including the nonsteroidal antiinflammatory meloxicam, are available, but information on their postoperative effects is limited. The objective of the present study was to compare buprenorphine (0.03 mg/kg SC twice daily for 3 d) with meloxicam (2 mg/kg SC initial dose followed by 1 mg/kg SC once daily for 2 d) by assessing parameters relating to postsurgical recovery in rats that underwent surgical implantation of radiotelemetric transducers. Rats treated after surgery with buprenorphine showed greater reductions in body weight, food consumption, locomotor activity, and nighttime heart rates than did meloxicam-treated rats. Buprenorphine and meloxicam treatments both had stimulatory effects on mean arterial pressure and daytime heart rate measurements, although effects on nighttime mean arterial pressure were greater in the buprenorphine-treated rats. In summary, the lesser physiologic changes associated with meloxicam, as compared with buprenorphine, suggest that meloxicam offers advantages for use as a postoperative analgesic after laparotomy and radiotelemetric transducer implantation in rats.

Topics: Analgesia; Analgesics, Opioid; Animals; Anti-Inflammatory Agents, Non-Steroidal; Blood Pressure; Body Weight; Buprenorphine; Feeding Behavior; Heart Rate; Male; Meloxicam; Motor Activity; Pain Measurement; Pain, Postoperative; Random Allocation; Rats; Rats, Sprague-Dawley; Thiazines; Thiazoles; Treatment Outcome

This study evaluated whether the automated behaviour recognition software 'HomeCageScan' (HCS) could detect behaviour changes and any positive analgesic effects in two mouse strains undergoing vasectomy (C3H/HeNCrl and C57BL/6). Another objective was to test the effectiveness of HCS in differentiating between the effects of each treatment relative to conventional manual analysis. Each control (unoperated) group consisted of four mice of each strain. They were either untreated mice, mice given meloxicam alone (10 mg/kg) or mice given either saline or meloxicam (10 mg/kg) 30 min prior to isoflurane anaesthesia. The vasectomized mice received either saline or meloxicam at 5, 10 or 20 mg/kg, again, 30 min prior to isoflurane anaesthesia. Filming began one hour following surgery. Each mouse was filmed for 6 min for the manual analysis and then for a further 20 min for analysis with HCS. In a time-matched test, HCS and the manual analysis produced activity data that generated identical conclusions regarding treatment effects and strain differences. Both HCS and the manual analysis found the C57BL/6 controls were overall more active, but not following vasectomy, when both types of analysis detected markedly reduced activity. Low-dose meloxicam (5 mg/kg) had a positive effect on postoperative mobility in the C3H/HeNCrl mice; however, increasing the dose rate progressively reduced this. These effects were also detected with the manual analysis. Overall, HCS provided a sufficiently accurate and rapid method of analysing mouse behaviour encouraging more prolonged assessments in the future. This capability and the possibility of training the software to recognize a greater range of behaviours, including pain-specific indicators, should be of considerable value for assessing postoperative behaviour in both mice and rats. This would allow analgesic requirements to be investigated in a greater range of rodent models than is currently feasible with conventional analysis methods.

Topics: Analgesics; Animals; Behavior, Animal; Body Weight; Male; Meloxicam; Mice; Mice, Inbred C3H; Mice, Inbred C57BL; Mice, Inbred Strains; Pain Measurement; Pain, Postoperative; Postoperative Period; Sensitivity and Specificity; Software; Thiazines; Thiazoles; Vasectomy

It is essential to identify objective and efficient methods of evaluating postoperative pain in rodents. The authors investigated whether postoperative changes in rates of body weight gain could serve as a measure of the efficacy of meloxicam or buprenorphine analgesia in growing rats. Young adult male Lewis rats underwent general endotracheal anesthesia and thoracotomy and were treated postoperatively for 3 d with saline (no analgesia), buprenorphine (six doses of 0.1 mg per kg) or meloxicam (three doses of 1 mg per kg). The authors evaluated rats' daily growth rates for 5 d after surgery and compared them with baseline (preoperative) growth rates. To discriminate between the effects of postoperative pain and other concurrent physiologic effects associated with anesthesia, thoracotomy or analgesia, the authors evaluated weight changes in multiple control groups. Treatment with buprenorphine in the absence of any other procedure or with anesthesia alone significantly affected rats' body weight. Notably, growth rate was maintained at near normal levels in rats treated postoperatively with meloxicam. These findings suggest that growth rate might serve as an efficient index of postoperative pain after major surgical procedures in young adult rats treated with meloxicam but not in rats treated with buprenorphine.

Topics: Analgesia; Analgesics, Opioid; Animals; Anti-Inflammatory Agents, Non-Steroidal; Body Weight; Buprenorphine; Intubation, Intratracheal; Meloxicam; Pain, Postoperative; Rats; Rats, Inbred Lew; Thiazines; Thiazoles; Thoracotomy; Weight Gain

This study aimed to develop a behaviour-based pain assessment system for rabbits following ovariohysterectomy. Behaviour was analysed to assess the severity and duration of pain induced and determine the effects of administration of meloxicam. The results suggest that pain associated with ovariohysterectomy induced changes in the frequency and duration of a number of behaviours. The most indicative was inactive pain behaviour, which was observed very infrequently prior to surgery compared to very frequently immediately following surgery. This strongly suggests that this increase is a direct response to the surgical pain and/or stress. The frequency of inactive pain behaviour also decreased over the four days post-surgery suggesting that pain is decreasing during this time. High dose meloxicam (initial 1mg/kg followed 0.5mg/kg/day) induced some degree of analgesia. However, higher doses of meloxicam or in combination with an opioid may be required to provide consistent analgesia in rabbits following soft-tissue surgery.

Topics: Analgesia; Animals; Animals, Laboratory; Anti-Inflammatory Agents, Non-Steroidal; Cyclooxygenase Inhibitors; Female; Hysterectomy; Meloxicam; Ovariectomy; Pain, Postoperative; Rabbits; Thiazines; Thiazoles

Behaviour was assessed in 32 C57BL/6JCrl and 32 C3H/HeN male mice 1 h following vasectomy; saline or meloxicam was administered 30 min prior to surgery at 5, 10, or 20 mg kg(-1). Faeces were collected 24 h prior to, and 3, 6, 9, 12, 24 h following, vasectomy for measurement of faecal corticosterone. Peak corticosterone levels were significantly higher in mice that underwent vasectomy and received saline (p<0.001) or meloxicam at 5 or 10 mg kg(-1) (p=0.021, and p<0.001, respectively) compared with normal un-operated controls. Mice that underwent vasectomy and received 20 mg kg(-1) meloxicam had peak corticosterone levels that were not different from normal un-operated mice (p=0.254). Discriminant analysis was used to identify behaviours responsible for group separation; these were summed to create two behaviour scores. Score 2 (the frequency of flinching, writhing, rear leg lift and press 2) was thought to be pain related; mice that underwent vasectomy and received saline exhibited significantly more of these behaviours than the normal controls (p=0.032), and the mice that received meloxicam (at any dose). Strain differences were observed in both the stress response to vasectomy and the behavioural changes; the C3H/HeN mice had higher pain scores (behaviour Score 2) and peak corticosterone responses than the C57BL/6JCrl mice. We have demonstrated that significant changes occur in the behaviour of mice following vasectomy, and these changes are reduced by use of meloxicam. Vasectomy elicits a rise in corticosterone levels that was only reduced by the highest dose of meloxicam.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Behavior, Animal; Body Weight; Corticosterone; Feces; Male; Meloxicam; Mice; Mice, Inbred C3H; Mice, Inbred C57BL; Pain Measurement; Pain, Postoperative; Species Specificity; Stress, Physiological; Thiazines; Thiazoles; Vasectomy

To compare the efficacy of meloxicam administered perioperatively with transdermal administration of fentanyl via a patch placed preoperatively in dogs undergoing orthopedic surgery.. Prospective study.. 16 dogs.. Unilateral or bilateral osteotomy of the tibia and fibula was surgically performed, and a uniplanar external distraction device was placed in each limb. Postoperative pain and lameness were assessed 24, 48, and 72 hours after administration of the first of 3 doses of meloxicam (0.2 mg/kg [0.09 mg/lb], IV, given preoperatively, followed by 0.1 mg/kg [0.045 mg/lb], IV, after 24 hours, and 0.1 mg/kg, PO, after 48 hours) or preoperative placement of a transdermal fentanyl patch (50 microg/h) left in place for 72 hours.. No significant differences in total pain scores were detected between groups. Mean +/- SD lameness scores assessed at 24 and 72 hours were lower in dogs in the meloxicam group than dogs in the fentanyl group. Lameness scores decreased with time in a similar manner in both treatment groups.. Perioperative administration of meloxicam or preoperative placement of a transdermal fentanyl patch provided effective and similar postoperative analgesia in dogs undergoing orthopedic surgery. However, because of its anti-inflammatory effects, treatment with meloxicam reduced the degree of lameness and resulted in rapid functional recovery of the limb.

Topics: Administration, Cutaneous; Analgesia; Analgesics, Non-Narcotic; Analgesics, Opioid; Animals; Anti-Inflammatory Agents, Non-Steroidal; Dog Diseases; Dogs; Fentanyl; Infusions, Intravenous; Meloxicam; Osteotomy; Pain Measurement; Pain, Postoperative; Perioperative Care; Postoperative Care; Prospective Studies; Random Allocation; Thiazines; Thiazoles; Time Factors; Treatment Outcome

Very little is known concerning the occurrence of pain in cancer research models. We wished to establish whether a behaviour-based approach, originally developed to assess postoperative pain, could be used to determine positive effects of the analgesics carprofen and meloxicam in rats that might be experiencing pain during tumour development in an orthotopic model of bladder cancer. An invasive but non-metastatic rat bladder cancer cell line was surgically implanted into the bladder wall of 57 inbred Fisher344 rats. The rats underwent daily clinical assessments. When clinical signs consistent with chronic pain were apparent, behavioural data were collected from 44 animals during 2 x 10 min periods, immediately before and one hour after a subcutaneous injection of either physiological saline (0.9%; 0.2 ml/100 g), carprofen (5 mg/kg) or meloxicam (2 mg/kg). Treatment-associated behaviour changes were then compared between groups. The lack of active behaviour, both before and after each treatment, was consistent with established clinical signs of pain. The rats were so inactive following the treatment that the behavioural technique we had previously developed was of comparatively little use in determining either pain severity or analgesic efficacy. One very prominent effect, however, was an increase in ventral abdominal licking in the control (saline) group. As this was absent in rats given meloxicam or carprofen, and has previously been considered to indicate pain emanating from damaged tissue, it was concluded that the analgesic-treated rats gained at least some benefit from the drug treatments, but it was not possible to gauge the extent of this. Handling for examination or treatment may have intensified pain in rats in the control group, and so this should be avoided whenever possible. It is likely that post-surgical pain differs markedly from cancer pain, so a different set of behavioural markers may be needed to assess it effectively. More intensive behaviour monitoring may help to develop a suitable technique for detecting the onset of, and assess the severity of pain that may occur during tumour development.

Topics: Analysis of Variance; Animals; Behavior, Animal; Carbazoles; Disease Models, Animal; Male; Meloxicam; Pain; Pain Measurement; Pain, Postoperative; Rats; Rats, Inbred F344; Thiazines; Thiazoles; Urinary Bladder Neoplasms

Topics: Analgesics, Non-Narcotic; Animals; Dog Diseases; Dogs; Meloxicam; Orthopedic Procedures; Pain, Postoperative; Thiazines; Thiazoles

This study was designed to compare the analgesic effects of butorphanol with those of meloxicam following ovariohysterectomy. Fifteen dogs were premedicated with 0.05 mg/kg body weight (BW) of acepromazine by intramuscular (IM) injection, plus 0.2 mg/kg BW of meloxicam by subcutaneous (SC) injection. Fifteen dogs were premedicated with 0.05 mg/kg BW of Acepromazine, IM, plus 0.2 mg/kg BW of butorphanol, IM. Anesthesia was induced with thiopental, and dogs were maintained on halothane. All pain measurements were performed by 1 experienced individual, blinded to treatment. Pain scores and visual analogue scales (VAS) were performed at 2, 3, 4, 6, 8, 12, and 24 hours postpremedication. An analgesiometer was used to determine the pressure required to produce an active avoidance response to pressure applied at the incision line. Pain scores, VAS, and analgesiometer scores were analyzed by using a generalized estimating equations method. A significance level of P < 0.05 was considered significant. Animals that received meloxicam demonstrated significantly lower pain scores and VAS than did animals that received butorphanol in the first 12 hours after surgery. Results of this study suggest that meloxicam will produce better postoperative analgesia than will butorphanol. Mucosal bleeding times were performed on cooperative animals in the study group (11 butorphanol, 13 meloxicam). Bleeding times were performed prior to premedication, 6 hours following premedication, and 24 hours after premedication. The 6- and 24-hour readings were compared with baseline bleeding times by using a paired t-test with a Bonferroni correction (a significance level of P < 0.025). Bleeding times did not change significantly over time.

Topics: Analgesics, Non-Narcotic; Analgesics, Opioid; Animals; Bleeding Time; Butorphanol; Dogs; Female; Hysterectomy; Meloxicam; Ovariectomy; Pain Measurement; Pain, Postoperative; Preanesthetic Medication; Random Allocation; Thiazines; Thiazoles; Time Factors; Treatment Outcome

We have recently demonstrated dose-related analgesic-induced reductions in the occurrence of 7 behavioural activities following midline laparotomy in rats. For these behaviours to be useful in evaluating pain in laboratory rats they must be shown to occur after different types of surgery, and frequently enough to allow rapid scoring of animals. Here, the relevant behaviours were used to test the analgesic efficacy of meloxicam with a variation of our previous laparotomy model. As part of an unrelated project, 57 male Fischer rats were divided into groups to receive either saline (0.2 ml/100g s.c.), meloxicam (0.5, 1 or 2 mg/kg s.c.) or carprofen (2.5, 5, or 10 mg/kg s.c.) 1h before surgery. Behaviour data were collected for 10 min following 25 min of recovery from isoflurane anaesthesia. The cumulative frequencies of back arching, fall/stagger, writhe and poor gait were used to compute a composite behaviour score. Irrespective of whether analyses included only 5 or all 10 min of the observation period, the relevant behaviours occurred significantly more often in rats given saline or low dose meloxicam than in those given 1 or 2 mg/kg of meloxicam, or any dose of carprofen. We conclude that this technique of quantifying post-surgery behaviour is an effective pain scoring method following abdominal surgery in rats, and that 1 mg/kg meloxicam significantly attenuates laparotomy induced pain. Since only a short observation period is required, this approach represents an important practical advance in assessing abdominal pain severity and clinical drug potency.

Topics: Abdominal Pain; Analgesics, Non-Narcotic; Animals; Anti-Inflammatory Agents, Non-Steroidal; Behavior, Animal; Body Weight; Carbazoles; Disease Models, Animal; Exploratory Behavior; Male; Meloxicam; Motor Activity; Pain Measurement; Pain, Postoperative; Rats; Rats, Inbred F344; Thiazines; Thiazoles; Time Factors

The analgesic efficacy of an epidural morphine/mepivacaine combination alone versus epidural morphine/mepivacaine in combination with meloxicam administered prior to the onset of anesthesia was assessed in 20 dogs undergoing cranial cruciate ligament repair. Numerical and visual analog pain scores were performed prior to anesthesia and at 6, 8, 12, 16, and 24 hours after epidural administration by a trained observer, blinded to treatment. An analgesiometer was used to determine the amount of pressure required to produce an avoidance response at the incision site. Animals that received meloxicam demonstrated a trend toward decreased pain scores over all time periods. Visual analog pain scores tended to be lower in dogs receiving meloxicam across all time periods, with a significant interaction between time and visual analog score at 6 and 8 hours (P < 0.05). No dogs receiving meloxicam required rescue analgesia, while 3 of 10 dogs in the epidural only group required rescue analgesia. Administration of meloxicam in addition to epidural morphine plus mepivacaine conveys improved analgesia as compared with epidural alone. Postoperative analgesia is reliably maintained for 24 hours following administration.

Topics: Analgesia; Analgesia, Epidural; Analgesics, Non-Narcotic; Analgesics, Opioid; Anesthetics, Local; Animals; Anterior Cruciate Ligament; Dogs; Meloxicam; Mepivacaine; Morphine; Pain Measurement; Pain, Postoperative; Random Allocation; Thiazines; Thiazoles; Treatment Outcome

Piglets are popular for studies of respiratory and cardiovascular function, but opioid analgesics are contraindicated in these studies because of central nervous system depression. We evaluated two nonopioid analgesics for postoperative pain relief following implantation of a central arterial catheter via an inguinal incision. Animals were randomly assigned to paracetamol-treated (n=8, rectal suppositories, 100 mg/kg) meloxicam-treated (n=8, 1 mg/kg meloxicam via the catheter) or untreated control group (n=8, placebo suppositories and normal saline). Additional controls received paracetamol or meloxicam, without pain (n=6 for both groups). Behavioral and physiological assessments, and blood sampling were undertaken at nine timed intervals until 24 h after surgery. Multifactorial numerical rating scale (NRS), behavioral and physiological pain scores (PPS) decreased over time for all groups (P<.001). On NRS and behavioral criteria, meloxicam was significantly better than paracetamol (P<.001), and both were better than control (p<.001 for each). Physiological parameters discriminated between the control and analgesia-treated groups, but not between paracetamol and meloxicam. Preliminary pharmacokinetics, determined by isocratic high-performance liquid chromatography (HPLC), revealed no difference in the half-life of paracetamol (2.5+/-0.3 h) vs. meloxicam (3.4+/-0.4 h). Paracetamol and meloxicam provided effective postoperative analgesia in piglets, with meloxicam superior to paracetamol on behavioral criteria.

Topics: Acetaminophen; Analgesics, Non-Narcotic; Animals; Behavior, Animal; Blood Pressure; Body Temperature; Half-Life; Heart Rate; Kidney; Liver; Meloxicam; Models, Biological; Pain Measurement; Pain, Postoperative; Respiratory Mechanics; Swine; Thiazines; Thiazoles

To compare the safety and efficacy of preoperative administration of meloxicam with that of ketoprofen and butorphanol in dogs undergoing abdominal surgery.. 36 dogs undergoing laparotomy, splenectomy, or cystotomy.. Dogs were randomly assigned to 1 of 3 groups. In the first part of the study, dogs were given a single dose of meloxicam, ketoprofen, or a placebo, and buccal mucosal bleeding times were measured. In the second part of the study, dogs were given meloxicam, ketoprofen, or butorphanol prior to surgery. Dogs in the butorphanol group received a second dose immediately after surgery. Pain scores (1 to 10) were assigned hourly for 20 hours after surgery and used to determine an overall efficacy score for each dog. Dogs with a pain score > or =3 were given oxymorphone for pain. Dogs were euthanatized 8 days after surgery, and gross and histologic examinations of the liver, kidneys, and gastrointestinal tract were conducted.. Overall efficacy was rated as good or excellent in 9 of the 12 dogs that received meloxicam, compared with 9 of the 12 dogs that received ketoprofen and only 1 of the 12 dogs that received butorphanol. No clinically important hematologic, biochemical, or pathologic abnormalities were detected.. Results suggest that preoperative administration of meloxicam is a safe and effective method of controlling postoperative pain for 20 hours in dogs undergoing abdominal surgery; the analgesic effects of meloxicam were comparable to those of ketoprofen and superior to those of butorphanol.

Topics: Analgesics, Non-Narcotic; Animals; Bleeding Time; Blood Pressure; Butorphanol; Cyclooxygenase Inhibitors; Dogs; Female; Hemostasis; Ketoprofen; Laparotomy; Male; Meloxicam; Narcotics; Pain, Postoperative; Random Allocation; Splenectomy; Thiazines; Thiazoles