To compare the onset of analgesic action of Piroxicam flash tablet (FT) with that of piroxicam regular (RT) in postoperative pain. Randomized, controlled, parallel-group trial. Indoor patients of the department of Orthopaedics, Government Medical College, Miraj. 39 men and women over 18 years of age undergoing orthopaedic operations and giving written informed consent for the study. Piroxicam Ft (10 mg) sublingually or piroxicam regular (10 mg) tablet orally, by randomized assignment. One tablet when patient demanded pain relief after operation and then one tablet in the morning and one in the evening for 7 days. Primary: onset of pain relief, defined as time in minutes required for initial pain intensity to fall by ≥ 50% as measure on a visual analogue scale (VAS), then before the morning and the evening doses for the 7 days, along with tenderness and inflammation scores. Secondary: Proportion of patients requiring addition analgesic for pain relief. 20 patients (13 M, 7 F; mean age 47.6 year [SD 15.32]) received FT, and 19 patients (12 M, 7 F; mean age 55.6 year [SD 21.32]) received RT. The time for onset of action was 10.42 minutes (SD 9.41) for FT and 18.83 minutes (SD 13.41) for RT. The difference of 8.4 minutes was significant by t-test (p = 0.036; 95% CI: -16.23 to -0.59). Both formulations showed a statistically significant reduction (p< 0.001) in pain, tenderness and inflammation as compared with baseline values. 3 of 20 patients (15 %) given FT and 6 of 19 patients (32%) given RT required additional analgesics (p = 0.63 by X2 test). Piroxicam FT has a faster onset of analgesic action as compared with piroxicam RT in pain following orthopaedic operations. The analgesic and anti-inflammatory activity of both the formulations are comparable
