Background: Surgical injury produces nociception, inflammation and hyperalgesia. Non-steroidal anti-inflammatory drugs (NSAIDs) if present at the site of surgical injury may retard or even inhibit the inflammatory response in the tissue. Meloxicam, a COX 2 preferential NSAID was chosen as the study drug because of its long elimination half life and its good tolerability with respect to local and systemic reactions Objectives: To compare the postoperative analgesia provided by a single dose oblique muscle infiltration of 15 mg Meloxicam with Meloxicam 15 mg/IM over the vastus lateralis muscle at the anterolateral thigh for patients undergoing emergency appendectomy and to determine whether there was any difference in the requirements for postoperative analgesia between the two groups Methods: 40 ASA I-II patients aged 18-65 years old with acute appendicitis scheduled for emergency appendectomy through a McBurneys incision under spinal anesthesia were included in this randomized prospective blinded study. Right after peritoneal closure, patients in DWI group (N=21) received local infiltration of meloxicam 15 mg while patients in the ATI group (N=19) received meloxicam 15 mg over the anterolateral thigh. VAS scores at different time intervals were noted at rest, upon movement by raising the shoulders off the bed, and upon coughing. A rescue dose of 10 mg/IV Nalbuphine was given as needed by the patient Results: There was no significant difference in the demographic variables between the two groups. Only the VAS scores upon movement showed statistically different results between the DWI group and the ATI group (RMANOVA, p0.05, Significant). The proportion of those patients who requested rescue analgesics and the mean amount of rescue analgesic was also statistically different between the two groups. Patients in the ATI group required rescue analgesics earlier than those in the DWI group (p0.05, Significant) Conclusion: Intramuscular wound infiltration with Meloxicam 15 mg resulted in lower VAS scores upon movement, less requirement for rescue analgesics, and longer time interval needed before the rescue analgesic is given. (Author)
Human ; Aged ; Middle Aged ; Adult ; Young Adult ; ANALGESIA ; APPENDECTOMY ; ANTI-INFLAMMATORY AGENTS ; NON-STEROIDAL ; ANALGESICS ; ANALGESICS ; NON-NARCOTICS ; INTRAOPERATIVE COMPLICATIONS