Oxycodone For Patient-controlled Analgesia Research Articles

Clinical Effect of Small-Dose Dexmedetomidine Combined with Oxycodone for Patient-Controlled Analgesia After Colon Cancer Surgery

This study aimed to elucidate the efficacy and safety of oxycodone combined with dexmedetomidine for patientcontrolled analgesia after colon cancer. Sixty patients were randomly divided into the experimental and control groups (n = 30 each). The control group received 0.5 mg/kg oxycodone. The experimental group received 0.5 mg/kg oxycodone and 2 μg/kg dexmedetomidine. Both groups were administered normal saline (NS) up to 100 mL (via background infusion at 2 mL/h with a 0.5-mL bolus dose and 15-min lockout interval). Both groups received oxycodone 0.1 mg/kg and tropisetron 5 mg, 20 min before the end of surgery. The MAP and HR of T1, T2, T3, and T4 were recorded in three groups. After the operation, a blinded observer assessed pain using the visual analogue scale (VAS) score, level of sedation (Ramsay score), and postoperative nausea and vomiting score at 2, 6, 24, 48 h. Side effects included dizziness, shivering, headache, and pruritus. The results showed that, in the experimental group, the T2∼T5 activity pain and T2∼T4 visceral pain VAS scores of patients were obviously lower than those in the control group (activity pain P T2∼T5 = 0.000, visceral pain P T2 = 0.018, P T3 = 0.001, P T4 = 0.010). The dosage of analgesic pump and number of rescue analgesia occurrences in the experimental group were far lower than those in the control group (P = 0.000 and P = 0.029, respectively). The time of first anus exhaust of the patients in the experimental group was obviously earlier than that of the control group (P = 0.030), and the number of vomiting occurrences of the patients in the experiment group was obviously lower than that in the control group (P = 0.023). No significant differences in the incidence of other adverse reactions were observed between the two groups within 48 h post-operation (P >0.05). In summary, oxycodone combined with dexmedetomidine can be safely and effectively used for analgesia after laparoscopic radical resection of colon cancer.

A Comparison of Patient-Controlled Analgesia with Oxycodone and Morphine After Total Abdominal Hysterectomy Surgery

We compared the analgesic profile between patient-controlled analgesia (PCA) using oxycodone and morphine in post total abdominal hysterectomy patients. Eighty-four ASA I or II patients, aged 18 to 65 years who underwent total abdominal hysterectomy were recruited into this prospective, double blind, randomised controlled study. They were randomised to receive either PCA oxycodone 0.7 mg per bolus or PCA morphine 1 mg per bolus for postoperative pain relief. At the end of surgery, all patients received IV morphine 0.1 mg/kg and skin incision was infiltrated with 20 mls of bupivacaine 0.25%. Post-operative pain scores, opioids consumptions, sedation scores and side effects were assessed upon arrival and at 30 minutes after arrival to recovery area, as well as at 6 hours and 24 hours after the operation in the ward. Patients’ overall satisfaction was also assessed 24 hours postoperatively.No significant differences were observed in terms of postoperative pain scores, opioids consumption, sedation scores, side effects as well as patient’s overall satisfaction between the PCA oxycodone and PCA morphine group. Oxycodone was comparable to morphine as PCA in terms of total opioid consumption, pain scores and satisfaction level for patients undergoing total abdominal hysterectomy and therefore may be an alternative to morphine in postoperative pain management as PCA.

Continuous Ropivacaine Infusion Offers No Benefit in Treating Postoperative Pain After Cardiac Surgery

One multimodal pain management method for reducing postoperative opioid need after cardiac surgery is to continuously infuse local anesthetic into a median sternotomy wound. Previous studies have shown contradictory results with this method; therefore, no consensus exists on its effectiveness. The authors tested the effectiveness of continuous 0.2% ropivacaine infusion into a sternotomy wound after cardiac surgery. Prospective, randomized, double-blinded, placebo-controlled trial. Single-institution, tertiary-level, university hospital. Total of 90 patients undergoing coronary artery bypass grafting or heart valve surgery. Patients were assigned randomly to receive 0.2% ropivacaine or placebo into a sternotomy wound for 48 hours postoperatively. Pain was controlled with standardized oxycodone boluses after surgery and patient-controlled analgesia oxycodone after extubation; total oxycodone consumption was recorded. Pain was assessed 3 times daily, at rest and during deep breathing, with the visual analogue scale. Forty-seven patients were assigned to receive ropivacaine and 43 to receive placebo infusion. Cumulative oxycodone consumption was 97 ± 27 mg with ropivacaine and 96 ± 29 mg with placebo (p = 0.813). Pain scores were similar between groups, both at rest (p = 0.630) and during deep breathing (p = 0.793). Adverse event incidences and surgical wound infection rates were similar between groups. Continuous 0.2% ropivacaine infusions at the median sternotomy wound did not reduce postoperative pain or opioid consumption during the first 48 hours after cardiac surgery. This technique apparently was not beneficial for post-sternotomy pain treatment.

A Randomized Clinical Trial of Nefopam versus Ketorolac Combined With Oxycodone in Patient-Controlled Analgesia after Gynecologic Surgery

Objectives: Nefopam is a centrally-acting non-opioid analgesic, which has no effect on bleeding time and platelet aggregation. There has been no study about nefopam and oxycodone combination for postoperative analgesia. In this study, we present efficacy and side effects of nefopam/oxycodone compared with ketorolac/oxycodone in patient-controlled analgesia (PCA) after gynecologic surgery.Methods: 120 patients undergoing gynecologic surgery were divided randomly into two groups: Nefopam group treated with oxycodone 1 mg and nefopam 1 mg bolus; and Ketorolac group treated with oxycodone 1 mg and ketorolac 1.5 mg bolus. After the operation, a blinded observer assessed the pain with a numeric rating scale (NRS), infused PCA dose and sedation score at 1, 4, 24, and 48 h, nausea, vomiting, headache, shivering, pruritus and delirium at 6, 24 and 48 h, and satisfaction at 48 h after the operation.Results: Nefopam group showed less nausea than Ketorolac group within 6 h after the operation. There were no significant differences in demographic data and other complications between both groups. At 48 h after operation, satisfaction and the infused PCA volumes of Nefopam group (34.0± 19.7 ml) showed no significant differences compared to Ketorolac group (30.7± 18.4 ml, P-value= 0.46).Conclusion: Nefopam showed a similar efficacy and lower incidence of nausea within 6 h after the operation to that of ketorolac in PCA. Nefopam may be a useful analgesic drug for the opioid-based PCA after gynecologic surgery. Further evaluation of accurate equivalent dose of nefopam as well as pharmacokinetics of bolus administration is required.

Efficacy and side effects of tramadol versus oxycodone for patient-controlled analgesia after maxillofacial surgery

Tramadol, a weak opioid μ-receptor agonist, may have a favourable potency and side effect profile for intravenous patient-controlled analgesia (PCA). In a prospective, double-blind, randomized study involving 54 patients, tramadol was compared with oxycodone in PCA after maxillofacial surgery. All the patients were given diclofenac sodium 1 mg kg -1 intramuscularly and dexamethasone 8mg twice a day. Post-operatively patients received tramadol or oxycodone by a PCA apparatus (lockout 5 min, tramadol 0.3 mg kg -1 bolus, oxycodone 0.03 mg kg -1 bolus). During the immediate recovery period, opioid was administered i.v. in a double-blind fashion, either tramadol 10 mg or oxycodone 1 mg increments until the pain control was judged to be satisfactory by the patient. Pain was assessed at rest and during activity (mouth opening) before and after loading, at 2 h after commencing the PCA, as well as at 21.00 and at 09.00 hours on the following morning. Side effects were recorded. The potency ratio of tramadol to oxycodone was found to be approximately 8:1. There was no significant difference between the groups in the VAS scores for pain. No respiratory depression was identified. Tramadol was found to provide adequate analgesia after maxillofacial surgery without risk of respiratory depression. However, the incidence of nausea was slightly greater in the tramadol group than in the oxycodone group (44% vs. 28%, NS).

Efficacy and side effects of tramadol versus oxycodone for patient-controlled analgesia after maxillofacial surgery

Tramadol, a weak opioid mu-receptor agonist, may have a favourable potency and side effect profile for intravenous patient-controlled analgesia (PCA). In a prospective, double-blind, randomized study involving 54 patients, tramadol was compared with oxycodone in PCA after maxillofacial surgery. All the patients were given diclofenac sodium 1 mg kg-1 intramuscularly and dexamethasone 8 mg twice a day. Post-operatively patients received tramadol or oxycodone by a PCA apparatus (lockout 5 min, tramadol 0.3 mg kg-1 bolus, oxycodone 0.03 mg kg-1 bolus). During the immediate recovery period, opioid was administered i.v. in a double-blind fashion, either tramadol 10 mg or oxycodone 1 mg increments until the pain control was judged to be satisfactory by the patient. Pain was assessed at rest and during activity (mouth opening) before and after loading, at 2 h after commencing the PCA, as well as at 21.00 and at 09.00 hours on the following morning. Side effects were recorded. The potency ratio of tramadol to oxycodone was found to be approximately 8:1. There was no significant difference between the groups in the VAS scores for pain. No respiratory depression was identified. Tramadol was found to provide adequate analgesia after maxillofacial surgery without risk of respiratory depression. However, the incidence of nausea was slightly greater in the tramadol group than in the oxycodone group (44% vs. 28%, NS).