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Intravenous tenoxicam reduces uterine cramps after Cesarean delivery

[Le ténoxicam intraveineux réduit les crampes utérines à la suite d'une césarienne]

Yu-Chen Huang, MD^*, Shen-Kou Tsai, PhD^*, Chi-Hsiang Huang, MD^*, Mao-Hsien Wang, MD, Pei-Lin Lin, MD^*, Li-Kuei Chen, MD^*, Chen-Jung Lin, MD^* and Wei-Zen Sun, MD^*

^* From the Departments of Anesthesiology, National Taiwan University Hospital, College of Medicine and Hospital, and
the En-Chu-Kong Hospital, Taipei, Taiwan.

Dr. Li-Kuei Chen, Department of Anesthesiology, National Taiwan University Hospital, No. 7, Chung-Shan South Rd., Taipei, Taiwan. Phone: 886-2-2312-3456 ext. 5516; Fax: 886-2-2341-5736; E-mail: clk0619{at}ane1.mc.ntu.edu.tw

Purpose: Postpartum uterine contraction pain is a common phenomenon after Cesarean delivery. We investigated the effectiveness of tenoxicam in reducing uterine contraction pain.

Methods: We enrolled 120 consecutive non-breastfeeding women who were scheduled for elective Cesarean delivery. After the administration of spinal anesthesia with bupivacaine and intrathecal morphine 0.15 mg injection, the patients were randomly divided into two groups. Group I received placebo (normal saline) iv injection, and Group II received tenoxicam 40 mg iv injection after clamping the umbilical cord. Verbal analogue scale of wound pain and uterine contraction pain were recorded at two, four, eight,16, and 24 hr after Cesarean delivery.

Results: There was no significant difference in wound pain scores between the two groups (all scores 3). However, the tenoxicam group had significant lower uterine contraction pain scores and required less supplemental meperidine medication than did the placebo group (8.5% vs 41.4%, P <0.05). The incidences of nausea or vomiting, pruritus, and bleeding were not significantly different between groups.

Conclusion: Intravenous tenoxicam 40 mg significantly reduced the intensity of uterine cramps in patients undergoing Cesarean delivery without increasing side effects.

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