The effect of intravenous tenoxicam on pruritus in patients receiving epidural fentanyl

In this prospective randomised study, pruritus and Cain were evaluated in patients undergoing abdominal surgery during which epidural fentanyl was administered. All patients had an epidural catheter inserted at the time of surgery. Epidural fentanyl 180 mu g was administered intra-operatively and infused at a concentration of 2 mu g.ml(-1) for 48 h postoperatively. All patients received a standard anaesthetic and, in addition, the study group had a 20 mg bolus of tenoxicam intravenously intra-operatively, Patients receiving tenoxicam demonstrated significantly lower pruritus and Cain scores at 30 min, 2, 4, 8 and 24 h postoperatively as well as reduced pethidine requirements for breakthrough pain in the first 24 h. In conclusion tenoxicam 20 mg significantly reduces the incidence and severity of postoperative pruritus in patients who received peri-operative epidural fentanyl. In addition, it significantly reduces pain and further analgesic requirements postoperatively.