mobiflex and Postoperative-Complications

Anaesthesia and surgery alter renal function. Inhibition of prostaglandin synthesis by non-steroidal anti-inflammatory drugs (NSAIDs) administered with anaesthesia may further compromise renal function.. To study the effects of tenoxicam (NSAID) administered immediately prior to anaesthesia on renal function in normal individuals undergoing routine surgery.. A randomised single blind placebo controlled study comparing tenoxicam (40 mg intravenously) with placebo was carried out in 20 healthy (ASA I) patients undergoing lower spinal surgery. Glomerular filtration rate (GFR) was determined by creatinine clearance and renal tubular function measured as osmolar and free water clearance.. GFR fell by 60% at the end of surgery but returned to pre-operative values by six hours post-operatively. There was no difference between placebo or tenoxicam with regard to changes in GFR. Tubular function was not altered by tenoxicam.. Current clinical practice of using NSAIDs for post-operative analgesia in low risk individuals appears to have no adverse effects on renal function.

Topics: Adult; Analysis of Variance; Anesthetics, Intravenous; Anti-Inflammatory Agents, Non-Steroidal; Female; Glomerular Filtration Rate; Humans; Intraoperative Complications; Kidney; Kidney Diseases; Laminectomy; Male; Pain, Postoperative; Piroxicam; Postoperative Complications; Premedication; Single-Blind Method; Urodynamics

147 patients due to have a cemented total hip arthroplasty were randomized to 4 groups. They received either tenoxicam 20 mg or 40 mg, or placebo, for 5 days or morphine on the day of operation and placebo for 4 days. During the first 5 days 14 patients were excluded. The patients were followed for 1 year, during which another 10 patients were excluded. At follow-up, significantly fewer patients had heterotopic ossifications in the tenoxicam groups than in the placebo and morphine groups. There was no significant difference between the 2 tenoxicam-treated groups, and we therefore conclude that tenoxicam 20 mg for 5 days postoperatively can reduce heterotopic ossification after cemented total hip arthroplasty.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Hip Prosthesis; Humans; Ossification, Heterotopic; Piroxicam; Postoperative Complications; Treatment Outcome

127 children scheduled for elective tonsillectomy or adenotonsillectomy were studied. Anaesthesia was induced with propofol and maintained with a volatile agent. At induction the child received either rectal diclofenac 1 mg.kg-1 with or without fentanyl 0.75 microgram.kg-1 i.v., or intravenous tenoxicam 0.4 mg.kg-1 with or without fentanyl 0.75 microgram.kg-1 i.v. Blood loss was measured peroperatively. Nausea and vomiting scores, sedation scores and pain scores were recorded in the recovery room, at one, two, four and eight h postoperatively and at discharge. There were no significant differences in blood loss between the groups or between nausea and vomiting scores. Pain scores in the tenoxicam without fentanyl group were significantly higher in recovery (P < 0.05) than the diclofenac group without fentanyl and both fentanyl groups. This group required supplemental analgesia earlier although this was not significant. The pain scores in the diclofenac with fentanyl group were significantly lower at one h and four h than the group receiving diclofenac alone (P = 0.008 and 0.02 respectively).

Topics: Adenoidectomy; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; Blood Loss, Surgical; Child; Diclofenac; Fentanyl; Humans; Nausea; Pain Measurement; Pain, Postoperative; Piroxicam; Postoperative Complications; Tonsillectomy; Vomiting

The effect of tenoxicam 10 mg and 20 mg, administered daily for 6 weeks to prevent heterotopic bone formation after total hip arthroplasty, was evaluated in a randomized, double-blind, placebo-controlled trial involving 90 patients. After 3 months, patients who had received the active drug, including those who had received only half the recommended anti-inflammatory dosage, had significantly less heterotopic bone formation. After 6 months the difference between treatment groups and placebo became smaller but remained significant. Adverse reactions occurred in only 3 patients, reflecting no differences between the groups. The study results, including radiographic, clinical and biochemical evaluations, demonstrate that treatment with tenoxicam 20 mg daily and even with tenoxicam 10 mg daily for 6 weeks, starting immediately after total hip arthroplasty, is effective in preventing ectopic bone formation.

Topics: Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Dose-Response Relationship, Drug; Double-Blind Method; Hip Prosthesis; Humans; Male; Middle Aged; Ossification, Heterotopic; Piroxicam; Postoperative Complications; Prospective Studies

Angioneurotic oedema is an acute swelling involving the submucosal or subcutaneous tissues; it is most often located in the oral and maxillofacial region, which can result in upper airway obstruction. Its aetiology is frequently associated with immunoglobulin-mediated hypersensitivity reactions that elicit a heightened inflammatory response. The objective of this study was to report the case of a patient who developed an episode of angioneurotic oedema following combined orthognathic surgery. Pharmacological and nonpharmacological interventions used in the treatment of this important clinical condition are described and discussed.

Topics: Angioedema; Anti-Inflammatory Agents; Epinephrine; Face; Facial Asymmetry; Female; Follow-Up Studies; Humans; Hydrocortisone; Lip Diseases; Mandible; Orthognathic Surgical Procedures; Osteotomy; Piroxicam; Postoperative Complications; Vasoconstrictor Agents; Young Adult

Post laminectomy arachnoiditis has been shown by experiments with rats and post operative radiological imaging in humans. The purpose of this experimental study was to determine the efficacy of tenoxicam in preventing arachnoiditis in rats. Twenty-four Wistar rats were divided into two groups, and L3 laminectomy was performed. In the tenoxicam group, 0.5 mg/kg tenoxicam was applied intraperitoneally. Normal saline was applied intraperitoneally in the control group. Later, the rats were killed at weeks 3 and 6, and the laminectomy sites were evaluated pathologically for arachnoiditis. The results showed that 6 weeks after surgery, the tenoxicam group showed lowest arachnoiditis grades. However, statistically significant difference was not found in arachnoiditis between the control group and the tenoxicam group. Based on these findings it is concluded that application of the tenoxicam after lumbar laminectomy did not effectively reduce arachnoiditis. Performing the most effective surgical technique without damage around tissue in a small surgical wound and having meticulous hemostasis in surgery seem to be the key for preventing arachnoiditis effectively.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Arachnoid; Arachnoiditis; Disease Models, Animal; Hemostasis, Surgical; Injections, Intraperitoneal; Laminectomy; Piroxicam; Postoperative Complications; Rats; Rats, Wistar; Treatment Failure

We determined whether tenoxicam administered intraperitoneally in the preoperative period had an effect on the development of postoperative intraabdominal adhesions (IAA). For this purpose, 100 albino mice were divided into four random groups. Mice in Group 1 were given only 1 mL of 0.9% NaCl intraperitoneally, whereas in Group 2, 1 mL of tenoxicam (150 microg = 5 mg/kg) was administered. After the induction of anesthesia, a median laparotomy was performed, and the bowels were traumatized by touching them with powdered gloves before the incision was closed in Groups 3 and 4. Intraperitoneal tenoxicam was administered to mice in Group 4 after skin closure. All mice were killed after 14 days to determine macroscopic and microscopic IAA; prostaglandin E2 levels were also measured. Postoperative evaluation revealed a reduced IAA formation and a parallel decrease in tissue prostaglandin E2 levels in Group 1 and 2 mice. We conclude that intraperitoneal tenoxicam decreased IAA formation with no peritoneal reaction in the postoperative period.. Postoperative intraabdominal adhesions can cause intestinal obstruction, pelvic pain, or infertility. In this study, we showed that intraperitoneally administered tenoxicam decreases tissue prostaglandin E2 levels and intraabdominal adhesions in mice.

Topics: Abdomen; Animals; Anti-Inflammatory Agents, Non-Steroidal; Dinoprostone; Female; Ileum; Injections, Intraperitoneal; Male; Mice; Peritoneal Diseases; Piroxicam; Postoperative Complications; Tissue Adhesions

Fifty patients undergoing colonic surgery received combined thoracic epidural and general anesthesia followed by continuous epidural bupivacaine 0.25% and morphine 0.05 mg/mL, 4 mL/h, for 96 h postoperatively plus oral tenoxicam 20 mg daily. Heart rate (HR) and arterial blood pressure (BP) were measured at supine rest, during orthostatic stress, and after walking prior to and 24, 48, and 72 h and 48 h postoperatively compared to preoperatively (P < or = 0.008); 16 vs 6 patients presented resting systolic BP values < 100 mm Hg (lower range, 70 mm Hg) post- versus preoperatively (P = 0.048). During orthostatic stress the decrease in systolic BP and concomitant increase in HR was similar post- versus preoperatively (BP, P > 0.3; HR, P > 0.34) and 12 vs 8 patient; (P = 0.45) experienced a systolic BP decrease > 20 mm Hg post- versus preoperatively. After walking, systolic BP was significantly lower postoperatively compared with preoperatively (P < or = 0.01). Epidural infusion was discontinued in three patients due to either persisting resting or orthostatic hypotension. There was no correlation between ASA classification, intraoperative bleeding, or postoperative dizziness and incidence of orthostatic hypotension. The results suggest that patients undergoing abdominal surgery and treated with continuous small-dose thoracic epidural bupivacaine-morphine are subjected to a decrease of BP at rest and during mobilization, but not to an extent that seriously impairs ambulation in most patients.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Analgesia, Epidural; Analgesics, Opioid; Anesthesia, Epidural; Anesthesia, General; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Blood Pressure; Bupivacaine; Colectomy; Female; Follow-Up Studies; Heart Rate; Humans; Hypotension, Orthostatic; Male; Middle Aged; Morphine; Piroxicam; Postoperative Complications; Rest; Supine Position; Thoracic Vertebrae; Walking