Effect of Intravenous Oxycodone Versus Sufentanil on the Incidence of Postoperative Nausea and Vomiting in Patients Undergoing Gynecological Laparoscopic Surgery

Abstract

More than 30% of patients who undergo surgery will experience postoperative nausea and vomiting (PONV) if no prophylactic treatments are used. Although numerous studies have been performed to investigate the factors related to PONV, the effect of perioperative intravenous oxycodone on the incidence of PONV has not been well investigated. In this study, gynecological patients (grade I-II, aged 18-65 years, scheduled to undergo elective gynecological laparoscopic surgery under general anesthesia) were randomized to the oxycodone group or the sufentanil group. In the oxycodone group, patients received intravenous oxycodone for the induction and maintenance of anesthesia, as well as postoperative analgesia, while sufentanil was used in the sufentanil group. The primary outcome variable was the incidence of PONV. As secondary outcomes, time to first PONV, the rating of the most severe PONV, postoperative pain scores at different time points, hemodynamics, and side effects were evaluated. We found that, compared with sufentanil, oxycodone decreased the incidence of PONV by 13.5% (P = .041). The time to first vomiting was longer in the oxycodone group than in the sufentanil group. Postoperative pain scores at different time points and hemodynamics were comparable between the oxycodone and sufentanil groups. We concluded that the incidence of PONV in gynecological patients who underwent laparoscopic surgery was lower when using intravenous oxycodone for anesthesia induction, anesthesia maintenance, and postoperative analgesia than when using intravenous sufentanil. However, oxycodone and sufentanil provided the same stable hemodynamics during surgery and satisfactory postoperative analgesia.

Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review

“…Tao et al . 67 reported that the incidence of PONV in gynecological patients who underwent laparoscopic surgery was lower when using intraoperative and postoperative intravenous (IV) oxycodone compared to IV sufentanil. However, Han et al .…”

<p>Oxycodone vs Sufentanil in Patient-Controlled Intravenous Analgesia After Gynecological Tumor Operation: A Randomized Double-Blind Clinical Trial</p>

“…Nevertheless, PONV were still observed in patients in all groups, and the incidence rate of PONV was more than 20% 24 hours after surgery, which is similar to previous studies. 31,32 However, patients with sufentanil PCIA showed higher incidence rate of PONV when compared with patients with oxycodone PCIA 24 and 48 hours after surgery, demonstrating the advantages of oxycodone over sufentanil in postoperative pain relief. Respiratory depression is one of the most concerned anesthesia-related adverse complications after surgery.…”

Comparison of Oxycodone and Sufentanil for intravenous patient-controlled analgesia after hip surgery: a prospective, randomized controlled trial

“…Pain is one of the major factors limiting early mobilization after hip surgery, resulting increased risks of thromboembolism and infection, or delayed postoperative rehabilitation, especially for the elderly patient [9,10]. Appropriate pain management is crucial, and there are several choices of techniques for postoperative analgesia including epidural block, peripheral nerve block, transdermal administration, and intravenous analgesics infusion.…”

“…Considering an estimated 20% dropout rate, 165 subjects in each group, and a total of 330 subjects are required. For the primary outcome of incidence of PONV, it is reported to be 38.8% in sufentanil and 25.3% in oxycodone [9]. Assuming the difference between two groups at a 2.5% significance level and a power of 0.80, 223 subjects are required in each group.…”