Abstract

BackgroundPostoperative visceral pain is common after surgery and previous studies have demonstrated that oxycodone is an effective treatment. In this study, we compared the effects of preemptive oxycodone to equal dose of sufentanil on postoperative pain and serum level of inflammatory factors (TNF-α, IL-6, IL-10) after laparoscopic cholecystectomy.MethodsForty patients undergoing laparoscopic cholecystectomy were randomized into preemptive oxycodone group or preemptive sufentanil group.Patients were given either oxycodone 0.1 mg/kg (oxycodone group, n = 20) or sufentanil 0.1 μg/kg (sufentanil group, n = 20) for preemptive analgesia. We evaluated pain/sedation scores at 0 h, 0.5 h, 2 h, 4 h, 6 h, 8 h and 24 h after surgery and measured serum concentrations of TNF-α, IL-6 and IL-10 before surgery and at 0 h, 6 h and 24 h after surgery.ResultsTwenty patients were recruited in each group. Numerical rating scale (NRS) of visceral pain in the oxycodone group at 2 h when resting (0.5(0,2.75) vs 3(2,4), P = 0.008) and moving (0.5(0,3) vs 3(2.25,4), P = 0.015) and 4 h when moving (2(0,3) vs 3(0,4.75), P = 0.043) after surgery were significantly lower than the sufentanil group. Serum concentrations of TNF-α at 6 h (38.68 ± 10.49 vs 73.02 ± 16.27, P<0.001) and 24 h (43.12 ± 8.40 vs 74.00 ± 21.30, P<0.001) in the oxycodone group were lower than the sufentanil group.ConclusionsPreemptive oxycodone 0.1 mg/kg administration could effectively suppress visceral pain at 2 h and 4 h after surgery and had lower inflammatory marker, serum TNF-α, level when compared to equal dose of sufentanil.Trial registrationClinical trials registration number: ChiCTR-IOR-17013738http://www.chictr.org.cn/showproj.aspx?proj=17346. Date of registration: 6th December 2017.

Highlights

  • Postoperative visceral pain is common after surgery and previous studies have demonstrated that oxycodone is an effective treatment

  • For patients undergoing Laparoscopic cholecystectomy (LC), preemptive oxycodone 0.1 mg/kg administration could effectively suppress visceral pain at 2 h and 4 h after surgery and inhibit the rising of serum TNF-α level at 6 h and 24 h after surgery without increasing postoperative complications

  • Preemptive oxycodone appears to be an effective strategy in dealing with visceral pain after LC

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Summary

Introduction

Postoperative visceral pain is common after surgery and previous studies have demonstrated that oxycodone is an effective treatment. We compared the effects of preemptive oxycodone to equal dose of sufentanil on postoperative pain and serum level of inflammatory factors (TNF-α, IL-6, IL-10) after laparoscopic cholecystectomy. Laparoscopic cholecystectomy (LC) carries short operation time, mild surgical trauma and minimal blood loss, which could greatly enhance recovery after surgery (ERAS) [1, 2]. Visceral pain is a major part of pain within 24 h after surgery [5] and is difficult to locate and lack targeted treatments. Morten et al [7] have shown that patients with higher visceral pain in the first week after LC were associated with chronic pain

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