Comparative efficacy of oxycodone with fentanyl for patient-controlled intravenous analgesia after radical operation of digestive tract tumor

Abstract

Objective To evaluate and compare the efficacy of oxycodone with fentanyl for patient-controlled intravenous analgesia after radical operation of digestive tract tumor. Methods Forty patients scheduled for selective radical operation of digestive tract tumor were randomly divided into two groups (n=20 each), oxycodone group and fentanyl group, from May to September 2015 in Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University. The patients were injected intravenously oxycodone 0.1 mg/kg in oxycodone group or fentanyl 1 μg/kg in fentanyl group at 30 minutes before the end of operation respectively. VAS was recorded after endotracheal extubation. Oxycodone 1 mg or fentanyl 0.05 mg was injected intravenously when the patients complained of pain, and administration was repeated if necessary until VAS ≤40 mm. Then patient-controlled intravenous analgesia (PCIA) (oxycodone 0.5 mg/ml or fentanyl 10 μg/ml in normal saline 100 ml) was used for postoperative analgesia respectively, lasting for 48 h. Pain at rest and cough was assessed using VAS at 0, 0.5, 3, 24 and 48 h after administration.Total dosage of oxycodone or fentanyl consumption, the number of delivered dose, requirement for rescue analgesics, the analgesia satisfaction, and the adverse events were recorded within 48 h after the operation. Results (1) VAS showed increase at first and then decrease in the two groups (P<0.05). The VAS at rest was significantly lower in oxycodone group than that in fentanyl group immediately after PCA (P<0.05). (2) The ratio of patients required rescue analgesics was twenty percent (4/20 cases) in oxycodone group, and sixty percent (12/20 case) in fentanyl group (χ2=5.104, P=0.024). (3) The number of delivered doses, total dosage of pain pumps, incidences of adverse event were significantly lower and analgesia satisfaction was significantly higher in oxycodone group than those in fentanyl group (P<0.05). Conclusion Oxycodone provides more reliable analgesic efficacy for PCIA after radical operation in patients with digestive tract tumor than fentanyl, with fewer adverse effects as compared with fentanyl. Key words: Oxycodone; Fentanyl; Anesthesia, general; Analgesia, patient-controlled; Pain, postoperative