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M Elhakim - One of the best experts on this subject based on the ideXlab platform.
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effects of intraperitoneal lidocaine combined with intravenous or intraperitoneal Tenoxicam on pain relief and bowel recovery after laparoscopic cholecystectomy
Acta Anaesthesiologica Scandinavica, 2000Co-Authors: M Elhakim, H Amine, S Kamel, F SaadAbstract:Background: Previous work has demonstrated that intraperitoneal (i.p.) lidocaine may provide analgesia after laparoscopic cholecystectomy. The aim of this prospective, randomized, double-blind study was to compare pain relief, recovery variables, and side effects after i.p. instillation of lidocaine plus Tenoxicam given either i.v. or i.p. after laparoscopic cholecystectomy. Methods: Ninety patients were randomly allocated to one of three groups to receive either 200 ml normal saline i.p. and 2 ml of normal saline i.v. (saline group), 200 ml lidocaine 0.1% i.p. and 2 ml Tenoxicam 20 mg i.v. (Tenoxicam i.v. group), or 200 ml lidocaine 0.1% with 20 mg Tenoxicam i.p. and 2 ml of normal saline i.v. (Tenoxicam i.p. group). The i.p. instillation was made under the right diaphragm and on the gall bladder bed. VAS pain scores at rest, on movement and during coughing, were measured 2, 4, 6, 12, and 24 h after operation. The time to first demand of analgesia, total analgesic requirement, recovery variables, and side effects were investigated. Results: In the Tenoxicam i.p. group, pain scores were significantly lower both at rest and on movement and analgesic consumption was reduced compared with the saline group (P<0.05). In the Tenoxicam i.v. group, pain scores at rest were significantly lower compared with the saline group. Although recovery of bowel function was significantly faster in the Tenoxicam i.p. group (P<0.05), there were no differences in any other recovery characteristics or incidence of nausea between the groups. Conclusion: Combination of intraperitoneal lidocaine and Tenoxicam provided better analgesia on movement, and faster return of bowel function compared with i.p. lidocaine and i.v. Tenoxicam during the 24 h period after surgery.
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topical Tenoxicam from pharyngeal pack reduces postoperative sore throat
Acta Anaesthesiologica Scandinavica, 2000Co-Authors: M Elhakim, A Siam, I Rashed, M H HamdyAbstract:Background: One puff of beclomethasone inhaler has been shown to reduce the incidence of sore throat following endotracheal intubation. The aim of this study was to determine the effect of a pharyngeal pack on the incidence of sore throat and whether Tenoxicam-impregnated gauze pack significantly influenced the frequency of sore throat. Methods: Eighty patients undergoing general anaesthesia for elective surgery of the nasal septum were evaluated. The anaesthetist sprayed the upper airway towards the trachea with one puff of beclomethasone inhaler (50 μg) before orotracheal intubation. Patients were randomly assigned to have either a 0.2% Tenoxicam- or a 0.9% saline-impregnated gauze pack in the oropharynx during operation. They were evaluated for occurrence and severity of postoperative sore throat by direct questions 12–24 h after surgery. Results: Four patients who experienced any symptoms in the Tenoxicam group scored mild sore throat compared to 16 patients in the control group scoring mild, gradually developing moderate or severe sore throat (P<0.01). No drug-related side effects were observed. Conclusion: The intraoperative use of a Tenoxicam-impregnated gauze pack is effective in reducing moderate or severe postoperative sore throat following the use of throat pack.
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intra articular Tenoxicam relieves post arthroscopy pain
Acta Anaesthesiologica Scandinavica, 1996Co-Authors: M Elhakim, A Fathy, M Elkott, M M SaidAbstract:Background: Nonsteroidal anti-inflammatory drugs have been documented to be effective in the treatment of postoperative pain. The aim of this study was to evaluate the analgesic effect of local intra-articular injection of Tenoxicam compared with intravenous injection on postoperative pain after arthroscopy. Methods: After day-case arthroscopy, 60 patients were randomized to receive either Tenoxicam 20 mg in 20 ml of normal saline intra-articularly and 2 ml of normal saline i.v., or 20 ml of normal saline intra-articularly and 2 ml Tenoxicam 20 mg i.v. Postoperative pain was assessed using a visual analogue scale and measuring analgesic requirements. Results: Pain scores were significantly lower in the intra-articular group at rest and during active flexion of the knee at 1,2 and 4 hours postoperatively and during walking at 6 hours postoperatively (P < 0.05). Significantly more patients in the intravenous group required supplemental opioid analgesia within the first 4 hours postoperatively (P < 0.05). Conclusion: Intra-articular Tenoxicam 20 mg provided better analgesia and decreased the requirements for postoperative analgesic compared with i.v. Tenoxicam 20 mg.
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i v Tenoxicam for analgesia during caesarean section
BJA: British Journal of Anaesthesia, 1995Co-Authors: M Elhakim, M NafieAbstract:We have studied the analgesic efficacy of a single i.v. dose of Tenoxicam 20 mg, given 10 min before induction of anaesthesia in 25 patients undergoing elective Caesarean section. Another group of 25 similar patients served as controls. Nalbuphine consumption in the first 24 h after operation was reduced by 50% when Tenoxicam was given. The median time to first request for analgesia was increased from 25 to 110 min in the Tenoxicam group. Subjective experiences of pain and sedation were significantly greater in the control group up to 24 h after operation. The haemodynamic variability after intubation was of shorter duration in the Tenoxicam group. There was no significant difference in incidence and severity of postoperative nausea and vomiting between the two groups. The surgeon's assessment of uterine relaxation and bleeding, using a visual analogue score, and infant well-being, as judged by Apgar score and cord blood-gas analysis, showed no significant difference between the two groups. There was no evidence of premature closure of the ductus arteriosus or pulmonary hypertension. We conclude that a single i.v. dose of Tenoxicam is a useful pretreatment to minimize the haemodynamic variability of light general anaesthesia at induction-delivery and in reducing 24 h postoperative opioid consumption.
Jerry P Nolan - One of the best experts on this subject based on the ideXlab platform.
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analgesia after day case knee arthroscopy double blind study of intra articular Tenoxicam intra articular bupivacaine and placebo
BJA: British Journal of Anaesthesia, 1997Co-Authors: T M Cook, J P Tuckey, Jerry P NolanAbstract:Arthroscopy of the knee is performed regularly on a day-case basis. Intra-articular bupivacaine produces transient analgesia and reports of analgesia using intra-articular morphine have produced conflicting results. Non-steroidal anti-inflammatory drugs given systemically can provide effective analgesia for this procedure. In this study we attempted to determine if intra-articular Tenoxicam provided useful analgesia after day-case arthroscopy. Sixty three ASA I-II patients were allocated randomly to one of three groups to receive 40 ml of a solution containing 0.9% saline (group Pla), 0.25% bupivacaine (group Bup) or Tenoxicam 20 mg (group Ten). The injection was made into the knee joint at the end of surgery, 10 min before tourniquet deflation. Verbal rating and visual analogue pain scores (at rest and on knee flexion), use of analgesia, mobilization and disturbance by pain at home were recorded for the next 48 h. There were no differences between pain scores in any of the three groups when tested at rest or on movement. Less analgesia was used in the first 24 h by patients in the Tenoxicam group but the difference in time to first analgesia was not statistically significant. Side effects and disturbance by pain were similar in all groups. The use of intra-articular Tenoxicam 20 mg at the end of arthroscopy reduced oral analgesic requirements during the first day after operation but did not alter patients' perception of pain.
Jagdishwar R Patel - One of the best experts on this subject based on the ideXlab platform.
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preparation structural analysis and properties of Tenoxicam cocrystals
International Journal of Pharmaceutics, 2012Co-Authors: Jagdishwar R Patel, Robert A Carlton, Thomas E Needham, C O Chichester, Frederick G VogtAbstract:Abstract Cocrystals of Tenoxicam, a non-steroidal anti-inflammatory drug, are screened, prepared, and characterized in this study. Nine Tenoxicam cocrystals were identified using solvent-drop grinding (SDG) techniques. Structural characterization was performed using powder X-ray diffraction (PXRD), differential scanning calorimetry, and multinuclear solid-state NMR (SSNMR). Thermal analysis, PXRD, and 1D SSNMR are used to detect solvates and phase mixtures encountered in SDG cocrystal screening. 2D SSNMR methods are then used to confirm cocrystal formation and determine structural aspects for selected cocrystals formed with saccharin, salicylic acid, succinic acid, and glycolic acid in comparison to Forms I and III of Tenoxicam. Molecular association is demonstrated using cross-polarization heteronuclear dipolar correlation (CP-HETCOR) methods involving 1 H and 13 C nuclei. Short-range 1 H– 13 C CP-HETCOR and 1 H– 1 H double-quantum interactions between atoms of interest, including those engaged in hydrogen bonding, are used to reveal local aspects of the cocrystal structure. 15 N SSNMR is used to assess ionization state and the potential for zwitterionization in the selected cocrystals. The Tenoxicam saccharin cocrystal was found to be similar in structure to a previously-reported cocrystal of piroxicam and saccharin. The four selected cocrystals yielded intrinsic dissolution rates that were similar or reduced relative to Tenoxicam Form III.
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preparation and structural characterization of amorphous spray dried dispersions of Tenoxicam with enhanced dissolution
Journal of Pharmaceutical Sciences, 2012Co-Authors: Jagdishwar R Patel, Robert A Carlton, Fnu Yuniatine, Thomas E Needham, Frederick G VogtAbstract:ABSTRACT Tenoxicam is a poorly soluble nonsteroidal anti-inflammatory drug. In this work, the solubility of Tenoxicam is enhanced using amorphous spray-dried dispersions (SDDs) prepared using two molar equivalents of l -arginine and optionally with 10%–50% (w/w) polyvinylpyrrolidone (PVP). When added to the dispersions, PVP is shown to improve physical properties and also assists in maintaining supersaturation in solution. The dispersions provide a twofold increase over equilibrium solubility at the same pH. The dispersions are characterized using electron microscopy, vibrational spectroscopy, diffuse-reflectance visible spectroscopy, and X-ray powder diffraction. The structures of the dispersions are probed using solid-state nuclear magnetic resonance (SSNMR) experiments applied to the 1 H, 13 C, and 15 N nuclei, including two-dimensional dipolar correlation experiments that detect molecular association and the formation of a glass solution between Tenoxicam, l -arginine, and PVP. Other aspects of the amorphous structure, including hydrogen-bonding interactions and the ionization state of Tenoxicam and l -arginine, are also explored using SSNMR methods. These methods are used to show that the SDDs contain an amorphous l -arginine salt of Tenoxicam in a glass solution that also includes PVP when present. Finally, the dispersions show only a minor decrease in chemical stability during accelerated stability studies relative to a crystalline form of Tenoxicam. © 2011 Wiley Periodicals, Inc. and the American Pharmacists Association.
D M Ohanlon - One of the best experts on this subject based on the ideXlab platform.
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intra articular Tenoxicam improves postoperative analgesia in knee arthroscopy
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 1999Co-Authors: Sallyann Colbert, Emer Curran, D M Ohanlon, Ray Moran, Maire MccarrollAbstract:Non Steroidal Anti-Inflammatory drugs have a well documented benefit in the relief of postoperative pain. This study was designed to compare the analgesic effect of intra-articular Tenoxicam 20 mg with intravenous Tenoxicam on postoperative pain in 88 patients undergoing day case knee arthroscopy. A prospective, double blind, randomized trial was performed. All patients received a standard general anesthetic. Patients in group A received 20 mg Tenoxicam made up to 40 ml with normal saline intra-articularly (ia) and 2 ml normal salineiv. Patients in group B received 40 ml normal saline intra-articularly and 2 ml, 20 mg of Tenoxicam,iv. Both groups of patients were similar with respect to age, weight, sex and tourniquet inflation time. Patients receivingia Tenoxicam had lower pain scores (at rest and upon movement) at 30, 60, 120 and 180 min postoperatively (0.8 ± 0.2vs 2.5 ± 0.2 at rest and 1.24 ± 0.2vs 3.4 ± 0.2 at movement at 60 min;P < 0.0001). Fewer patients required additional analgesia in the first four hours postoperatively (33%vs 84%;P < 0.00001) and the time to first analgesia (23.7 ± 11.2 vs 9.4 ± 0.6; P < 0.02) was longer in those receivingia Tenoxicam, Intra-articular Tenoxicam provides superior postoperative analgesia and reduces postoperative analgesic requirements compared withiv Tenoxicam in patients undergoing day case knee arthroscopy.
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a prospective study comparing intravenous Tenoxicam with rectal diclofenac for pain relief in day case surgery
European Journal of Anaesthesiology, 1998Co-Authors: S A Colbert, D M Ohanlon, Connail Mccrory, M Scully, A Tanner, M DoyleAbstract:In a prospective, randomized, double-blind study, we compared intravenous Tenoxicam with rectal diclo- fenac for post-operative pain relief after day case arthroscopy or laparoscopic sterilization. Intravenous Tenoxicam (40 mg) was administered as a single bolus at induction, or rectal diclofenac (100 mg) was administered immediately after induction. Both groups were similar with respect to age, weight, sex of the patients, the operation performed and the operative time. There were no significant differences observed between the groups for pain scores at 30 min, 60 min and 24 h post-operatively. The time to first analgesic requirement, the dose of pethidine administered and total analgesic requirements in the first 24 h post-operatively were equivalent in both groups. In view of the similar efficacy of both of these drugs, patient preference and ease of administration, the use of Tenoxicam is appropriate in many patients undergoing day case surgery.
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analgesia in day case breast biopsy the value of pre emptive Tenoxicam
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 1998Co-Authors: Sallyann T Colbert, D M Ohanlon, Conor Mcdonnell, Fred H Given, Padraic W KeaneAbstract:agent) was compared with post-incision Tenoxicam for the relief of post-operative pain in 77 patients undergoing day case breast biopsy. Methods: All patients received a standard general anaesthetic which included infiltration of the wound with bupivacaine after skin closure. Intravenous Tenoxicam (20 mg) was administered as a single bolus either 30 min before surgery (37 patients) or after incision (40 patients). Pain scores (I00 mm visual analog scale) were obtained at 30, 60, 120 and 240 rain after surgery analgesic requirements recorded. Results: Both groups of patients were similar with respect to age, weight, operative time and length of the incision. Patients receiving the Tenoxicam 30 min before surgery had lower pain scores at 30 min (22_ ___ 3) vs 46 __. 3; P < 0.0001 ), 60 min (9 ___ 2 vs 28 ___ 3); P < 0.0001), 120 min (6 --- 2 vs 16 __. 3); P = 0.0002) and 240 min (3 - I) vs 7 --- 2); P = 0.02) post-operatively.
Alicia Garcialopez - One of the best experts on this subject based on the ideXlab platform.
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comparison of Tenoxicam and bromazepan in the treatment of fibromyalgia a randomized double blind placebo controlled trial
Pain, 1996Co-Authors: Jesus Quijadacarrera, Angel Valenzuelacastano, Juan Povedanogomez, Antonia Fernandezrodriguez, Wenceslao Hernanzmediano, Antonio Gutierrezrubio, Jose Luis De La Iglesiasalgado, Alicia GarcialopezAbstract:Fibromyalgia is a painful syndrome of non-articular origin, predominantly involving muscles, and the commonest cause of chronic widespread musculoskeletal pain. The diversity of therapeutic programs for patients with fibromyalgia reflects both the lack of a known pathophysiology for this disorder and the low efficacy of the current therapies. We studied the efficacy of Tenoxicam and bromazepan in the treatment of patients with fibromyalgia. One hundred and sixty-four patients from our Rheumatology Outpatient Clinic fulfilling the American College of Rheumatology criteria for the classification of fibromyalgia, with widespread pain at study entry. Each of the 164 patients was randomly assigned to 1 of 4 treatment groups: double placebo (P), Tenoxicam (20 mg) + placebo (T), bromazepan (3 mg) + placebo (B)m or Tenoxicam (20 mg) + bromazepan 3 mg (TB). Patient global assessment of disease, pain, sleep quality, morning stiffness, and number of tender points were evaluated at baseline and 8 weeks afterwards. At the end of the trial, 17%, 10%, 12%, and 29% of the P, T, B, and TB patients, respectively, had clinical improvement. A statistically significant difference was found only between the T and TB groups. Our data indicate that treatment with Tenoxicam + bromazepan can be effective for some patients with fibromyalgia, but the differences with the placebo group were neither clinically nor statistically significant.
