Safety and Efficacy of Perioperative Intravenous Meloxicam for Moderate-to-Severe Pain Management in Total Knee Arthroplasty: A Randomized Clinical Trial
Abstract Objective To evaluate the effect of perioperative meloxicam IV 30 mg on opioid consumption in primary total knee arthroplasty (TKA). Design Multicenter, randomized, double-blind, placebo-controlled trial. Subjects In total, 181 adults undergoing elective primary TKA. Methods Subjects receiv...
Gespeichert in:
| Veröffentlicht in: | Pain medicine (Malden, Mass.) Mass.), 2021-06, Vol.22 (6), p.1261-1271 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1271 |
|---|---|
| container_issue | 6 |
| container_start_page | 1261 |
| container_title | Pain medicine (Malden, Mass.) |
| container_volume | 22 |
| creator | Berkowitz, Richard D Steinfeld, Richard Sah, Alexander P Mack, Randall J McCallum, Stewart W Du, Wei Black, Libby K Freyer, Alex Coyle, Erin |
| description | Abstract
Objective
To evaluate the effect of perioperative meloxicam IV 30 mg on opioid consumption in primary total knee arthroplasty (TKA).
Design
Multicenter, randomized, double-blind, placebo-controlled trial.
Subjects
In total, 181 adults undergoing elective primary TKA.
Methods
Subjects received meloxicam 30 mg or placebo via an IV bolus every 24 hours, the first dose administered prior to surgery as part of a multimodal pain management protocol. The primary efficacy parameter was total opioid use from end of surgery through 24 hours.
Results
Meloxicam IV was associated with less opioid use versus placebo during the 24 hours after surgery (18.9 ± 1.32 vs 27.7 ± 1.37 mg IV morphine equivalent dose; P |
| doi_str_mv | 10.1093/pm/pnab016 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8185557</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A700446136</galeid><oup_id>10.1093/pm/pnab016</oup_id><sourcerecordid>A700446136</sourcerecordid><originalsourceid>FETCH-LOGICAL-c503t-781ef0d0a4988d3158309db986d9d8648fc4a32996562124889c9d0e19bb2ad93</originalsourceid><addsrcrecordid>eNp9kl1rFDEUhgdR7Ife-AMkIIII0yaTSTbphbAsVYtdLHa9DtnJyTYlk4yZ2aXrP_HfmmHXakUkF_l6zvvyHk5RvCD4hGBJT7v2tAt6iQl_VBwSVvGy5nTyeH-u6IQdFEd9f4szUQv6tDiglOGKUXpY_LjWFoYt0sGgc2tdo5stihZdQXKxg6QHtwF0EYakNxDiukdz8PEucy2yMaF5NCME5RDLa9hAAnSlXUBzHfQKWggDyrdFHLRHnwIAmqbhJsXO637YnqEp-pKdY-u-g0Ez70IW9miRnPbPiidW-x6e7_fj4uv788XsY3n5-cPFbHpZNgzToZwIAhYbrGsphKGECYqlWUrBjTQi57VNrWklJWe8IlUthGykwUDkcllpI-lx8W6n262XLZgGxqxedcm1Om1V1E49_AnuRq3iRgkiGGOTLPBmL5DitzX0g2pd34D3OkBumMqehHPK-Ii--gu9jesUcjxVsVpWlaRS_KZW2oNywcbs24yiajrBuK45oTxTJ_-g8jLQuiYGsC6_Pyh4uytoUuz7BPY-I8FqHCTVtWo_SBl--WdX7tFfk5OB1zsgrrv_Cf0ExOLRbA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2549229398</pqid></control><display><type>article</type><title>Safety and Efficacy of Perioperative Intravenous Meloxicam for Moderate-to-Severe Pain Management in Total Knee Arthroplasty: A Randomized Clinical Trial</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Berkowitz, Richard D ; Steinfeld, Richard ; Sah, Alexander P ; Mack, Randall J ; McCallum, Stewart W ; Du, Wei ; Black, Libby K ; Freyer, Alex ; Coyle, Erin</creator><creatorcontrib>Berkowitz, Richard D ; Steinfeld, Richard ; Sah, Alexander P ; Mack, Randall J ; McCallum, Stewart W ; Du, Wei ; Black, Libby K ; Freyer, Alex ; Coyle, Erin</creatorcontrib><description>Abstract
Objective
To evaluate the effect of perioperative meloxicam IV 30 mg on opioid consumption in primary total knee arthroplasty (TKA).
Design
Multicenter, randomized, double-blind, placebo-controlled trial.
Subjects
In total, 181 adults undergoing elective primary TKA.
Methods
Subjects received meloxicam 30 mg or placebo via an IV bolus every 24 hours, the first dose administered prior to surgery as part of a multimodal pain management protocol. The primary efficacy parameter was total opioid use from end of surgery through 24 hours.
Results
Meloxicam IV was associated with less opioid use versus placebo during the 24 hours after surgery (18.9 ± 1.32 vs 27.7 ± 1.37 mg IV morphine equivalent dose; P < 0.001) and was superior to placebo on secondary endpoints, including summed pain intensity (first dose to 24 hours postdosing, first dose to first assisted ambulation, and first dose to discharge) and opioid use (48–72 hrs., 0–48 hrs., 0–72 hrs., hour 0 to end of treatment, and the first 24 hours after discharge). Adverse events (AEs) were reported for 69.9% and 92.0% of the meloxicam IV and placebo groups, respectively; the most common AEs were nausea (40% vs. 59%), vomiting (16% vs 22%), hypotension (14% vs 15%), pruritus (15% vs 11%), and constipation (11% vs 13%).
Conclusions
Perioperative meloxicam IV 30 mg as part of a multimodal analgesic regimen for elective primary TKA reduced opioid consumption in the 24-hour period after surgery versus placebo and was associated with a lower incidence of AEs typically associated with opioid use.</description><identifier>ISSN: 1526-2375</identifier><identifier>EISSN: 1526-4637</identifier><identifier>DOI: 10.1093/pm/pnab016</identifier><identifier>PMID: 33502533</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Acute, Regional, Anesthesiology & Perioperative Pain Section ; Analgesics ; Arthroplasty (knee) ; Blindness ; Clinical trials ; Constipation ; Dosage and administration ; Drug therapy ; Hypotension ; Intravenous administration ; Joint replacement surgery ; Joint surgery ; Meloxicam ; Methods ; Morphine ; Narcotics ; Nausea ; Opioids ; Pain ; Pain management ; Pain, Postoperative ; Perioperative care ; Placebos ; Pruritus ; Surgery ; Testing ; Vomiting</subject><ispartof>Pain medicine (Malden, Mass.), 2021-06, Vol.22 (6), p.1261-1271</ispartof><rights>The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. 2021</rights><rights>The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.</rights><rights>COPYRIGHT 2021 Oxford University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-781ef0d0a4988d3158309db986d9d8648fc4a32996562124889c9d0e19bb2ad93</citedby><cites>FETCH-LOGICAL-c503t-781ef0d0a4988d3158309db986d9d8648fc4a32996562124889c9d0e19bb2ad93</cites><orcidid>0000-0003-3252-3765</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33502533$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Berkowitz, Richard D</creatorcontrib><creatorcontrib>Steinfeld, Richard</creatorcontrib><creatorcontrib>Sah, Alexander P</creatorcontrib><creatorcontrib>Mack, Randall J</creatorcontrib><creatorcontrib>McCallum, Stewart W</creatorcontrib><creatorcontrib>Du, Wei</creatorcontrib><creatorcontrib>Black, Libby K</creatorcontrib><creatorcontrib>Freyer, Alex</creatorcontrib><creatorcontrib>Coyle, Erin</creatorcontrib><title>Safety and Efficacy of Perioperative Intravenous Meloxicam for Moderate-to-Severe Pain Management in Total Knee Arthroplasty: A Randomized Clinical Trial</title><title>Pain medicine (Malden, Mass.)</title><addtitle>Pain Med</addtitle><description>Abstract
Objective
To evaluate the effect of perioperative meloxicam IV 30 mg on opioid consumption in primary total knee arthroplasty (TKA).
Design
Multicenter, randomized, double-blind, placebo-controlled trial.
Subjects
In total, 181 adults undergoing elective primary TKA.
Methods
Subjects received meloxicam 30 mg or placebo via an IV bolus every 24 hours, the first dose administered prior to surgery as part of a multimodal pain management protocol. The primary efficacy parameter was total opioid use from end of surgery through 24 hours.
Results
Meloxicam IV was associated with less opioid use versus placebo during the 24 hours after surgery (18.9 ± 1.32 vs 27.7 ± 1.37 mg IV morphine equivalent dose; P < 0.001) and was superior to placebo on secondary endpoints, including summed pain intensity (first dose to 24 hours postdosing, first dose to first assisted ambulation, and first dose to discharge) and opioid use (48–72 hrs., 0–48 hrs., 0–72 hrs., hour 0 to end of treatment, and the first 24 hours after discharge). Adverse events (AEs) were reported for 69.9% and 92.0% of the meloxicam IV and placebo groups, respectively; the most common AEs were nausea (40% vs. 59%), vomiting (16% vs 22%), hypotension (14% vs 15%), pruritus (15% vs 11%), and constipation (11% vs 13%).
Conclusions
Perioperative meloxicam IV 30 mg as part of a multimodal analgesic regimen for elective primary TKA reduced opioid consumption in the 24-hour period after surgery versus placebo and was associated with a lower incidence of AEs typically associated with opioid use.</description><subject>Acute, Regional, Anesthesiology & Perioperative Pain Section</subject><subject>Analgesics</subject><subject>Arthroplasty (knee)</subject><subject>Blindness</subject><subject>Clinical trials</subject><subject>Constipation</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Hypotension</subject><subject>Intravenous administration</subject><subject>Joint replacement surgery</subject><subject>Joint surgery</subject><subject>Meloxicam</subject><subject>Methods</subject><subject>Morphine</subject><subject>Narcotics</subject><subject>Nausea</subject><subject>Opioids</subject><subject>Pain</subject><subject>Pain management</subject><subject>Pain, Postoperative</subject><subject>Perioperative care</subject><subject>Placebos</subject><subject>Pruritus</subject><subject>Surgery</subject><subject>Testing</subject><subject>Vomiting</subject><issn>1526-2375</issn><issn>1526-4637</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kl1rFDEUhgdR7Ife-AMkIIII0yaTSTbphbAsVYtdLHa9DtnJyTYlk4yZ2aXrP_HfmmHXakUkF_l6zvvyHk5RvCD4hGBJT7v2tAt6iQl_VBwSVvGy5nTyeH-u6IQdFEd9f4szUQv6tDiglOGKUXpY_LjWFoYt0sGgc2tdo5stihZdQXKxg6QHtwF0EYakNxDiukdz8PEucy2yMaF5NCME5RDLa9hAAnSlXUBzHfQKWggDyrdFHLRHnwIAmqbhJsXO637YnqEp-pKdY-u-g0Ez70IW9miRnPbPiidW-x6e7_fj4uv788XsY3n5-cPFbHpZNgzToZwIAhYbrGsphKGECYqlWUrBjTQi57VNrWklJWe8IlUthGykwUDkcllpI-lx8W6n262XLZgGxqxedcm1Om1V1E49_AnuRq3iRgkiGGOTLPBmL5DitzX0g2pd34D3OkBumMqehHPK-Ii--gu9jesUcjxVsVpWlaRS_KZW2oNywcbs24yiajrBuK45oTxTJ_-g8jLQuiYGsC6_Pyh4uytoUuz7BPY-I8FqHCTVtWo_SBl--WdX7tFfk5OB1zsgrrv_Cf0ExOLRbA</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Berkowitz, Richard D</creator><creator>Steinfeld, Richard</creator><creator>Sah, Alexander P</creator><creator>Mack, Randall J</creator><creator>McCallum, Stewart W</creator><creator>Du, Wei</creator><creator>Black, Libby K</creator><creator>Freyer, Alex</creator><creator>Coyle, Erin</creator><general>Oxford University Press</general><scope>TOX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3252-3765</orcidid></search><sort><creationdate>20210601</creationdate><title>Safety and Efficacy of Perioperative Intravenous Meloxicam for Moderate-to-Severe Pain Management in Total Knee Arthroplasty: A Randomized Clinical Trial</title><author>Berkowitz, Richard D ; Steinfeld, Richard ; Sah, Alexander P ; Mack, Randall J ; McCallum, Stewart W ; Du, Wei ; Black, Libby K ; Freyer, Alex ; Coyle, Erin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c503t-781ef0d0a4988d3158309db986d9d8648fc4a32996562124889c9d0e19bb2ad93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acute, Regional, Anesthesiology & Perioperative Pain Section</topic><topic>Analgesics</topic><topic>Arthroplasty (knee)</topic><topic>Blindness</topic><topic>Clinical trials</topic><topic>Constipation</topic><topic>Dosage and administration</topic><topic>Drug therapy</topic><topic>Hypotension</topic><topic>Intravenous administration</topic><topic>Joint replacement surgery</topic><topic>Joint surgery</topic><topic>Meloxicam</topic><topic>Methods</topic><topic>Morphine</topic><topic>Narcotics</topic><topic>Nausea</topic><topic>Opioids</topic><topic>Pain</topic><topic>Pain management</topic><topic>Pain, Postoperative</topic><topic>Perioperative care</topic><topic>Placebos</topic><topic>Pruritus</topic><topic>Surgery</topic><topic>Testing</topic><topic>Vomiting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Berkowitz, Richard D</creatorcontrib><creatorcontrib>Steinfeld, Richard</creatorcontrib><creatorcontrib>Sah, Alexander P</creatorcontrib><creatorcontrib>Mack, Randall J</creatorcontrib><creatorcontrib>McCallum, Stewart W</creatorcontrib><creatorcontrib>Du, Wei</creatorcontrib><creatorcontrib>Black, Libby K</creatorcontrib><creatorcontrib>Freyer, Alex</creatorcontrib><creatorcontrib>Coyle, Erin</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pain medicine (Malden, Mass.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Berkowitz, Richard D</au><au>Steinfeld, Richard</au><au>Sah, Alexander P</au><au>Mack, Randall J</au><au>McCallum, Stewart W</au><au>Du, Wei</au><au>Black, Libby K</au><au>Freyer, Alex</au><au>Coyle, Erin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety and Efficacy of Perioperative Intravenous Meloxicam for Moderate-to-Severe Pain Management in Total Knee Arthroplasty: A Randomized Clinical Trial</atitle><jtitle>Pain medicine (Malden, Mass.)</jtitle><addtitle>Pain Med</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>22</volume><issue>6</issue><spage>1261</spage><epage>1271</epage><pages>1261-1271</pages><issn>1526-2375</issn><eissn>1526-4637</eissn><abstract>Abstract
Objective
To evaluate the effect of perioperative meloxicam IV 30 mg on opioid consumption in primary total knee arthroplasty (TKA).
Design
Multicenter, randomized, double-blind, placebo-controlled trial.
Subjects
In total, 181 adults undergoing elective primary TKA.
Methods
Subjects received meloxicam 30 mg or placebo via an IV bolus every 24 hours, the first dose administered prior to surgery as part of a multimodal pain management protocol. The primary efficacy parameter was total opioid use from end of surgery through 24 hours.
Results
Meloxicam IV was associated with less opioid use versus placebo during the 24 hours after surgery (18.9 ± 1.32 vs 27.7 ± 1.37 mg IV morphine equivalent dose; P < 0.001) and was superior to placebo on secondary endpoints, including summed pain intensity (first dose to 24 hours postdosing, first dose to first assisted ambulation, and first dose to discharge) and opioid use (48–72 hrs., 0–48 hrs., 0–72 hrs., hour 0 to end of treatment, and the first 24 hours after discharge). Adverse events (AEs) were reported for 69.9% and 92.0% of the meloxicam IV and placebo groups, respectively; the most common AEs were nausea (40% vs. 59%), vomiting (16% vs 22%), hypotension (14% vs 15%), pruritus (15% vs 11%), and constipation (11% vs 13%).
Conclusions
Perioperative meloxicam IV 30 mg as part of a multimodal analgesic regimen for elective primary TKA reduced opioid consumption in the 24-hour period after surgery versus placebo and was associated with a lower incidence of AEs typically associated with opioid use.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>33502533</pmid><doi>10.1093/pm/pnab016</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-3252-3765</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1526-2375 |
| ispartof | Pain medicine (Malden, Mass.), 2021-06, Vol.22 (6), p.1261-1271 |
| issn | 1526-2375 1526-4637 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8185557 |
| source | Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Acute, Regional, Anesthesiology & Perioperative Pain Section Analgesics Arthroplasty (knee) Blindness Clinical trials Constipation Dosage and administration Drug therapy Hypotension Intravenous administration Joint replacement surgery Joint surgery Meloxicam Methods Morphine Narcotics Nausea Opioids Pain Pain management Pain, Postoperative Perioperative care Placebos Pruritus Surgery Testing Vomiting |
| title | Safety and Efficacy of Perioperative Intravenous Meloxicam for Moderate-to-Severe Pain Management in Total Knee Arthroplasty: A Randomized Clinical Trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-12T11%3A26%3A35IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Safety%20and%20Efficacy%20of%20Perioperative%20Intravenous%20Meloxicam%20for%20Moderate-to-Severe%20Pain%20Management%20in%20Total%20Knee%20Arthroplasty:%20A%20Randomized%20Clinical%20Trial&rft.jtitle=Pain%20medicine%20(Malden,%20Mass.)&rft.au=Berkowitz,%20Richard%20D&rft.date=2021-06-01&rft.volume=22&rft.issue=6&rft.spage=1261&rft.epage=1271&rft.pages=1261-1271&rft.issn=1526-2375&rft.eissn=1526-4637&rft_id=info:doi/10.1093/pm/pnab016&rft_dat=%3Cgale_pubme%3EA700446136%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2549229398&rft_id=info:pmid/33502533&rft_galeid=A700446136&rft_oup_id=10.1093/pm/pnab016&rfr_iscdi=true |