The effectiveness of preemptive piroxicam analgesia in abdominal surgery

Surgical trauma increases postoperative pain and its duration by producing nociceptive sensitization. This sensitization can be prevented by preemptive analgesia and the result is decrease in postoperative pain. The effectiveness of piroxicam that is used for preemptive analgesia has been investigated in this randomized, double-blind, placebo controlled study. Sixty patients undergoing elective laparotomy were randomly allocated into three groups. Group I (n=20) were given piroxicam 40 mg, IM the night before the operation, Group II (n=20) were given piroxicam 40 mg, IM at the end of the operation and Group III were given 2 mLs of saline solution as placebo by IM route the night before the operation. Postoperative analgesia was provided by meperidine through epidural catheter with PCA device. Visual Analog Scores (VAS), total meperidine dosages and opioid side effects were recorded hourly and evaluated in the first 24 hours following operation. VAS values on 0,1,2,3,4,8,12 and 24 th hours and total meperidine doses on 4,8,12,24th hours were significantly differed between groups I and III. VAS values on 4,8,12 and 24th hours and total meperidine doses on 8,12 and 24th hours differed significantly between groups II and III. As a result it has been concluded that piroxicam which is used for preemptive analgesia in elective abdominal surgery is an effective drug with better VAS scores and less opioid demand in postoperative period