The Effect of Oxycodone on Post-operative Pain and Inflammatory Cytokine Release in Elderly Patients Undergoing Laparoscopic Gastrectomy.

Wei-Long Lao,Wen-Di Chen,Zong-Ming Jiang,Qi-Liang Song,Xian-He Zheng,Zhong-Hua Chen

doi:10.3389/fmed.2021.700025

Abstract

Background: To evaluate the effect of oxycodone on post-operative pain and inflammation in elderly patients undergoing laparoscopic gastrectomy.Methods: Sixty patients who were of both sexes, American Society of Anesthesiologists Physical Status (ASA-PS) Class I or II, over 65 years of age and undergoing an elective laparoscopic radical gastrectomy were randomly divided into two groups: an oxycodone group (Group O) including 20 males and 10 females and a sufentanil group (Group S) including 21 males and 9 females. The post-operative analgesia regimen was as follows: 40 mg of parecoxib sodium and 0.1 mg/kg of oxycodone was intravenously injected into Group O before the abdomen closure, while 40 mg of parecoxib sodium and 0.1 μg/kg of sufentanil was injected intravenously into Group S. Both groups were infiltrated with 20 ml of 1% ropivacaine at the end of the operation. The level of serum IL-6 and IL-10 were assayed immediately at the following timepoints: at the conclusion of surgery (T1), 1 h (T2), 6 h (T3), and 24 h (T4) after the completion of the surgery. The numerical rating scale (NRS), the Ramsay sedation score, analgesic-related adverse events, post-operative pulmonary inflammation events and the post-operative stay were recorded.Results: Compared with Group S, the serum IL-6 concentrations of Group O decreased at T3 and T4, while the serum IL-10 concentrations increased (P < 0.05). In Group O, the serum IL-6 concentrations at T3 and T4 were lower than those at T1 (P < 0.05). The incidence of post-operative nausea and vomiting (PONV) and pulmonary inflammation in Group O was lower than that in Group S (P < 0.05). At each time point, the NRS of visceral pain in Group O was lower than that in Group S. At 6 and 24 h after extubation, the NRS of incision pain in Group O was lower than that in Group S (P < 0.05).Conclusion: Oxycodone can regulate the level of inflammatory cytokines and reduce post-operative inflammatory response.

Highlights

To evaluate the effect of oxycodone on post-operative pain and inflammation in elderly patients undergoing laparoscopic gastrectomy
Sixty patients who were of both sexes, American Society of Anesthesiologists Physical Status (ASA-PS) Class I or II, over 65 years of age and undergoing an elective laparoscopic radical gastrectomy were randomly divided into two groups: an oxycodone group (Group O) including 20 males and 10 females and a sufentanil group (Group S) including 21 males and 9 females
This study aims to evaluate the effect of oxycodone hydrochloride on postoperative pain and inflammation in elderly patients undergoing a laparoscopic radical gastrectomy for gastric cancer, so as to provide a reference for clinical research

Summary

Introduction

To evaluate the effect of oxycodone on post-operative pain and inflammation in elderly patients undergoing laparoscopic gastrectomy. Post-operative pain is a common adverse reaction of elderly patients after a laparoscopic radical gastrectomy for gastric cancer. Sufentanil, an opioid analgesic, is often used as a pure μ receptor agonist, and we often increase its dose to avoid the occurrence of analgesia deficiency. It increases the incidence of post-operative nausea and vomiting [10]. Oxycodone is a semi-synthetic opioid analgesic, which can effectively relieve visceral pain by stimulating μ and κ receptors, especially κ receptors, and it has fewer adverse reactions than other opioid drugs [11, 12]. In view of the κ receptor agonist effect of oxycodone, its analgesic effect on visceral pain is better than that of the μ receptor agonist alone [12, 14]

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