Comparison of analgesic efficacy of oxycodone and morphine in postoperative intravenous patient‐controlled analgesia

Silvasti, M.; Rosenberg, P. H.; Seppαlä, Timo; Svartling, N.; Pitkänen, M.

doi:10.1111/j.1399-6576.1998.tb05169.x

Cited by 148 publications

(128 citation statements)

References 17 publications

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“…6,7) It was synthesized as a half synthetic conductor of tebain, a natural alkaloid, in 1916. Compared with morphine, the analgesic effect is just as good or 2/3 as good, 8) the adverse effects are just as bad, 9) and delirium and nausea/vomiting episodes are fewer.…”

Section: Discussionmentioning

confidence: 98%

Pharmacokinetics and Variation in the Clearance of Oxycodone and Hydrocotarnine in Patients with Cancer Pain

Kokubun

Fukawa

Matoba

et al. 2007

Biological & Pharmaceutical Bulletin

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Compound injections of oxycodone and hydrocotarnine are currently used as one of the treatment options for some cases with cancer pain. However, there have been no reports examining the factors that influence oxycodone and hydrocotarnine clearance, so detailed examination is necessary. As for hydrocotarnine, there have been no reports examining the pharmacokinetics. Therefore in this study, we determined the pharmacokinetics of oxycodone and hydrocotarnine in patients with cancer pain. The study was conducted on 19 patients, in whom pain control was attempted by using the compound injections of oxycodone and hydrocotarnine. We used HPLCelectrochemical detector (ECD) to determine oxycodone and hydrocotarnine serum concentrations, and used the nonlinear least-squares method (MULTI) for calculation of the pharmacokinetic parameters. Furthermore, we examined the factors that influence the clearance of oxycodone and hydrocotarnine by multiple regression analysis (step wise method). The pharmacokinetic parameters were as follows: Oxycodone; V d ‫5.501؎7.622؍‬ l (mean؎S.D.), CL‫1.52؎9.73؍‬ l/h, t 1/2 ‫9.1؎1.4؍‬ h. Hydrocotarnine; V d ‫2.732؎8.672؍‬ l, CL‫3.46؎1.59؍‬ l/h, t 1/2 ‫7.0؎0.2؍‬ h. The clearance of oxycodone represented by a regression formula was significantly correlated to the age, the presence or absence of within 7 d on the death or liver metastasis, or of the heart failure of the patients. The clearance of hydrocotarnine represented by a regression formula was significantly correlated to the presence or absence of within 7 d on the death or liver metastasis, or of the heart failure of the patients. The clearance also indicated that oxycodone concentration in the blood was likely to be higher in patients having these factors. Oxycodone/hydrocotarnine compound injections should be used with caution and dose reduction may be necessary in such populations.

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Section: Discussionmentioning

confidence: 98%

Pharmacokinetics and Variation in the Clearance of Oxycodone and Hydrocotarnine in Patients with Cancer Pain

Kokubun

Fukawa

Matoba

et al. 2007

Biological & Pharmaceutical Bulletin

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“…Only 10% of the oxycodone dose is excreted unchanged in the urine [2][3][4][5]. The predominant metabolic pathway of oxycodone is CYP3A4-mediated Ndemethylation to noroxycodone, while a small part of the oxycodone undergoes 3-O-demethylation to oxymorphone by CYP2D6 [5,6].…”

Section: Introductionmentioning

confidence: 99%

Effects of itraconazole on the pharmacokinetics and pharmacodynamics of intravenously and orally administered oxycodone

Saari

Grönlund

Hagelberg

et al. 2010

Eur J Clin Pharmacol

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“…Its pharmacological actions are known to be similar to those of morphine but with a larger analgesic effect; oxycodone can relieve neuropathic and somatic pain, even of malignant origin with a swift time-to-effect and with a drug effect that lasts up to 12 hours. 9) A comparative analysis by Silvasti et al 10) found that in patients who received spinal fusion surgery or breast reduction and had undergone IV PCA oxycodone and morphine showed similar analgesic efficacies when oxycodone was administered as bolus doses of 30 µg/kg (3 mg/ml) without basal infusion; of those who were administered oxycodone, 18 of 24 patients presented with PONV. Taking the results of these studies into consideration, we lowered the basal rate of oxycodone to 0.7 mg/ml per hour and administered the opioid as boluses of 0.35 mg in order that complications associated with oxycodone are minimized.…”

Section: Discussionmentioning

confidence: 99%

An Analysis on the Effect of Patient-controlled Analgesia Performed by Orthopaedic Department or Postoperative Pain Control after Shoulder and Elbow Surgery

Yum¹,

Kim²,

Boo³

et al. 2015

Clinics in Shoulder and Elbow

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Background: We investigated the effectiveness of pain management and the adverse events of intravenous (IV) patient-controlled analgesia (PCA) after orthopedic surgery. Methods: From September 2014 and August 2015, we performed a retrospective analysis of 77 patients who underwent orthopedic surgery of the shoulder or the elbow in our hospital. The composition of the intravenous PCA administered to the patients was as follows: 250 mg of dexketoprofen trametamol, 70 mg of oxycodone, and 0.6 mg of ramosetron, which were made up to 79 ml of normal saline. We evaluated and statistically analyzed the difference in the visual analogue scale (VAS) scores for pain at immediate postoperation, at 24 hours of PCA, at 72 hours of PCA, and after discontinuation of PCA and in the incidence of adverse events. Results: We found that VAS score decreased for 3 postoperative days and that with discontinuation of IV PCA a meaningful change in VAS score was no longer seen. Of the 77 patients, 22 presented with adverse events (28.6%). We terminated IV PCA temporarily in the 21 patients who presented with adverse events; we terminated analgesia permanently in one patient (1.2%). Consequently, 76 of 77 patients carried out IV PCA till the designated period. Conclusions: Intravenous PCA after orthopedic surgery of the shoulder or the elbow may be accompanied with adverse events. Careful assessment of the patient and treatment of the adverse outcomes are key to a successful maintenance of PCA and to a successful management of postoperative pain. (Clin Shoulder Elbow 2015;18(4):237-241)

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Comparison of analgesic efficacy of oxycodone and morphine in postoperative intravenous patient‐controlled analgesia

Abstract: The same dose of intravenous oxycodone and morphine administered by PCA pump was needed for immediate postoperative analgesia. The two drugs appear to be equipotent.

Cited by 148 publications

References 17 publications

Pharmacokinetics and Variation in the Clearance of Oxycodone and Hydrocotarnine in Patients with Cancer Pain

Pharmacokinetics and Variation in the Clearance of Oxycodone and Hydrocotarnine in Patients with Cancer Pain

Effects of itraconazole on the pharmacokinetics and pharmacodynamics of intravenously and orally administered oxycodone

An Analysis on the Effect of Patient-controlled Analgesia Performed by Orthopaedic Department or Postoperative Pain Control after Shoulder and Elbow Surgery

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