• Medicine · Mar 2017

    Randomized Controlled Trial Comparative Study

    Oxycodone versus fentanyl for intravenous patient-controlled analgesia after laparoscopic supracervical hysterectomy: A prospective, randomized, double-blind study.

    • Nan Seol Kim, Jeong Seok Lee, Su Yeon Park, Aeli Ryu, Hea Rim Chun, Ho Soon Chung, Kyou Sik Kang, Jin Hun Chung, Kyung Taek Jung, and Seong Taek Mun.
    • aDepartment of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Cheonan, 23-20, Byeongmyeong-dong, Dongnam-gu, Cheonan, Chungcheongnam-do bDepartment of anesthesiology and pain medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon-si, Gyeonggi-do cDepartment of Biostatistics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul dDepartment of obstetrics and gynecology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan-si, Chungcheongnam-do, Republic of Korea.
    • Medicine (Baltimore). 2017 Mar 1; 96 (10): e6286.

    BackgroundOxycodone, a semisynthetic thebaine derivative opioid, is widely used for the relief of moderate to severe pain. The aim of this study was to compare the efficacy and side effects of oxycodone and fentanyl in the management of postoperative pain by intravenous patient-controlled analgesia (IV-PCA) in patients who underwent laparoscopic supracervical hysterectomy (LSH).MethodsThe 127 patients were randomized to postoperative pain treatment with either oxycodone (n = 64, group O) or fentanyl group (n = 63, group F). Patients received 7.5 mg oxycodone or 100 μg fentanyl with 30-mg ketorolac at the end of anesthesia followed by IV-PCA (potency ratio 75:1) for 48 hours postoperatively. A blinded observer assessed postoperative pain based on the numerical rating scale (NRS), infused PCA dose, patient satisfaction, sedation level, and side effects.ResultsAccumulated IV-PCA consumption in group O was less (63.5 ± 23.9 mL) than in group F (85.3 ± 2.41 mL) during the first 48 hours postoperatively (P = 0.012). The NRS score of group O was significantly lower than that of group F at 4 and 8 hours postoperatively (P < .001); however, the incidence of postoperative nausea and vomiting (PONV), dizziness, and drowsiness was significantly higher in group O than in group F. Patient satisfaction was lower in group O than in group F during the 48 hours after surgery (P < 0.001).ConclusionsOxycodone IV-PCA (potency ratio 1:75) provided superior analgesia to fentanyl IV-PCA after LSH; however, the higher incidence of side effects, including PONV, dizziness, and drowsiness, suggests that the doses used in this study were not equipotent.

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