A Comparative Analysis of Transitional Analgesia with Oxycodone and Sufentanil in Patients with Early Esophageal Carcinoma Undergoing Endoscopic Submucosal Dissection

Abstract

Background: Postoperative pain management is a critical consideration in patients undergoing endoscopic submucosal dissection (ESD) for early esophageal carcinoma. Conventional transitional analgesia methods involve the administration of either oxycodone or sufentanil. However, the efficacy of oxycodone in the context of patients with early esophageal carcinoma undergoing ESD under general anesthesia remains uncertain. This study aims to compare the postoperative analgesic effects of oxycodone and sufentanil in patients undergoing ESD for early esophageal carcinoma patients under general anesthesia. Methods: In this randomized double-blind controlled study, 86 patients scheduled for ESD surgery under general anesthesia were enrolled. They were randomly assigned to the oxycodone group (O group, n = 29), sufentanil group (S group, n = 30), or normal saline group (N group, n = 26) using a double-blind method. Thirty minutes before the end of the surgery, patients in the O group received oxycodone (0.1 mg/kg), those in the S group received sufentanil (0.1 μg/kg), and those in the N group received an identical volume of normal saline. Various parameters, including general patient conditions, intraoperative anesthetic medication, vital sign variations throughout the perioperative period, postoperative recovery duration, decannulation time, and adverse reactions during the recovery period were meticulously recorded. Visual Analog Scale (VAS) scores at rest and during movement at 0 h, 12 h, and 24 h post-surgery, along with the incidence of pain relief and malignant vomiting, were also documented. Results: No statistically significant differences were observed in general patient conditions, intraoperative anesthetic dosages, or vital sign changes among the three groups. However, patients in the O group exhibited significantly prolonged recovery and decannulation times compared to the S and N groups,without impeding overall recovery. Statistically significant differences in adverse reactions during the recovery period were observed (P<0.05). Furthermore, patients in the O group demonstrated decreased VAS scores at 0 h, 12 h, and 24 h post-surgery, regardless of rest or movement, compared to the S and N groups. Although VAS scores in the S group were significantly reduced at postoperative 0 h and 12 h at rest compared to the N group, no significant differences were noted in the reduction of VAS scores during movement. The incidence of severe vomiting did not significantly differ among the three postoperative groups. Conclusion: When compared with sufentanil, oxycodone exhibited more prolonged and comprehensive analgesic effects in patients undergoing esophageal ESD under general anesthesia, with no significant side effects. These findings contribute to our understanding of transitional analgesia strategies in this specific patient population.