Abstract
BackgroundIntravenous opioids are administered for the management of visceral pain after laparoscopic surgery. Whether oxycodone has advantages over other opioids in the treatment of visceral pain is not yet clear.MethodsIn this study, the analgesic efficiency and adverse events of oxycodone and other opioids, including alfentanil, sufentanil, fentanyl, and morphine, in treating post-laparoscopic surgery visceral pain were evaluated. This review was conducted according to the methodological standards described in the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. The PubMed, Embase, and Cochrane databases were searched in December 2019.ResultsTen studies were included in this review. The sample size was 695 participants. The results showed that compared with morphine and fentanyl, oxycodone had a more potent analgesic efficacy on the first day after laparoscopic surgery, especially during the first 0.5 h. There was no significant difference in sedation between the two groups. Compared to morphine and fentanyl, oxycodone was more likely to lead to dizziness and drowsiness. Overall, patient satisfaction did not differ significantly between oxycodone and other opioids.ConclusionsOxycodone is superior to other analgesics within 24 h after laparoscopic surgery, but its adverse effects should be carefully considered.
Highlights
Intravenous opioids are administered for the management of visceral pain after laparoscopic surgery
The results showed that oxycodone significantly reduced pain intensity compared with other opioids at 30 min (2 randomized-controlled trials (RCTs), N = 218, MD − 11.9, 95% confidence interval (CI) -16.16 to − 7.63), 4 h (3 RCTs, N = 290, MD − 4.73, 95% CI − 8.9 to − 0.57), and 24 h postoperatively (2 RCTs, N = 208, MD − 3.00, 95% CI − 4.02 to − 1.98) but not at 48 h postoperatively (2 RCTs, N = 208, MD − 0.62, 95% CI − 3.00 to 1.76) (Fig. 3)
Summary of findings A total of 9 studies, including 695 patients, were included in this meta-analysis to compare the analgesic effect of oxycodone and other opioids, including fentanyl, morphine, sufentanil, and alfentanil
Summary
Intravenous opioids are administered for the management of visceral pain after laparoscopic surgery. Whether oxycodone has advantages over other opioids in the treatment of visceral pain is not yet clear. Visceral pain is one of the most frequent reasons that patients seek medical attention after laparoscopic surgery [5]. Opioids are the most commonly provided analgesics for postoperative visceral pain, as they can be used prior to the completion of the operation or in the patientcontrolled analgesia (PCA) pump after surgery [1]. Which kind of opioid is most appropriate is still controversial. Oxycodone is a semisynthetic drug that is derived from thebaine, an opium alkaloid, and acts as a μ-opioid
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