Equianalgesic Dose Ratios for Opioids

Pereira, João Pablo Fortes; Lawlor, Peter G.; Viganò, Antonio; Dorgan, Marlene; Bruera, Éduardo

doi:10.1016/s0885-3924(01)00294-9

Cited by 467 publications

(90 citation statements)

References 33 publications

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“…Parenteral oxycodone appears to be equipotent with morphine 8. Morphine has a 1:80-100 potency ratio compared to fentanyl 12. In this study, however, the oxycodone group showed significantly less cumulative PCA dose to maintain the NRS values comparable with that of the fentanyl group.…”

Section: Discussioncontrasting

confidence: 55%

Oxycodone vs. Fentanyl Patient-Controlled Analgesia after Laparoscopic Cholecystectomy

Hwang¹,

Kwon²,

Kim³

et al. 2014

Int. J. Med. Sci.

106

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Objectives Oxycodone is semi-synthetic opioid, oral and parenteral preparations have been widely used for acute and chronic pain. The aim of this study was to assess the efficacy and side effects of oxycodone and fentanyl in patient controlled analgesia (PCA) after laparoscopic cholecystectomy.Methods A prospective, randomized, double-blind study was conducted. 81 patients were randomly divided into two groups; fentanyl (10 mcg fentanyl and 1.5 mg ketorolac) and oxycodone group (1 mg oxycodone and 1.5 mg ketorolac). After the operation, a blinded observer assessed pain using a numerical rating scale (NRS), infused PCA dose, side effects, sedation levels, and satisfaction.Results Cumulative PCA dose of oxycodone group at 48 h (31.4 ± 16.0 ml) was significantly less than that of fentanyl group (43.8 ± 23.1 ml, P = 0.009). Oxycodone group showed more nausea at 6 - 24 h after the operation (P = 0.001), but there was no difference in satisfaction score (P = 0.073). There were no significant differences in other side effects, sedation and NRS scores between two groups.Conclusion Oxycodone showed comparable effects for pain relief compared to fentanyl in spite of less cumulative PCA dose. Based on these results, we could conclude that oxycodone may be useful as an alternative to fentanyl for PCA after laparoscopic cholecystectomy.

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Section: Discussioncontrasting

confidence: 55%

Oxycodone vs. Fentanyl Patient-Controlled Analgesia after Laparoscopic Cholecystectomy

Hwang¹,

Kwon²,

Kim³

et al. 2014

Int. J. Med. Sci.

106

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“…Third, although the concept of equianalgesic doses of opioids allows comparison of opioids of varying potencies 41, 42 , these calculations are over-simplifications which do not take into account the many factors that contribute to the potency of a given analgesic in a particular individual 42 . Conversion calculations often vary from publication to publication 43 and are particularly problematic for methadone and fentanyl 44, 45 . There are limited data published on equianalgesic calculations for sublingual, rather than parenteral or transdermal, buprenorphine.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for opioid overdose and awareness of overdose risk among veterans prescribed chronic opioids for addiction or pain

Wilder

Miller

Tiffany

et al. 2015

Journal of Addictive Diseases

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Background Rising overdose fatalities among US veterans suggest veterans taking prescription opioids may be at risk for overdose. However, it is unclear whether veterans prescribed chronic opioids are aware of this risk. Objectives The objective of this study was to identify risk factors and determine awareness of risk for opioid overdose in veterans treated with opioids for chronic pain, using veterans treated with methadone or buprenorphine for opioid use disorder as a high-risk comparator group. Methods Ninety veterans on chronic opioid medication for either opioid use disorder or pain management completed a questionnaire assessing risk factors, knowledge, and self-estimate of risk for overdose. Results Nearly all veterans in both groups had multiple overdose risk factors although individuals in the pain management group had on average a significantly lower total number of risk factors than did individuals in the opioid use disorder group (5.9 v. 8.5, p<0.0001). On average, participants treated for pain management scored slightly but significantly lower on knowledge of opioid overdose risk factors (12.1 v. 13.5, p<0.01). About 70% of participants, regardless of group, believed their overdose risk was below that of the average American adult. There was no significant relationship between self-estimate of overdose risk and either number or knowledge of opioid overdose risk factors. Discussion Our results suggest that veterans in both groups underestimated their risk for opioid overdose. Expansion of overdose education to include individuals on chronic opioids for pain management and a shift in educational approaches to overdose prevention may be indicated.

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“…38-40 There is also insufficient evidence to guide specific recommendations for performing opioid rotation. Dose conversion tables and rotation protocols are available, 103 and generally suggest that a switch to a new drug should be accompanied by a moderate (usually 25-50%) reduction in the calculated equianalgesic dose. However, this method does not apply to cases in which patients are being rotated to methadone (see Section 4).…”

Section: Recommendationsmentioning

confidence: 99%

Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain

Chou

Fanciullo

Fine

et al. 2009

The Journal of Pain

1,870

1,609

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Use of chronic opioid therapy for chronic noncancer pain has increased substantially. The American Pain Society and the American Academy of Pain Medicine commissioned a systematic review of the evidence on chronic opioid therapy for chronic noncancer pain and convened a multidisciplinary expert panel to review the evidence and formulate recommendations. Although evidence is limited, the expert panel concluded that chronic opioid therapy can be an effective therapy for carefully selected and monitored patients with chronic noncancer pain. However, opioids are also associated with potentially serious harms, including opioid-related adverse effects and outcomes related to the abuse potential of opioids. The recommendations presented in this document provide guidance on patient selection and risk stratification; informed consent and opioid management plans; initiation and titration of chronic opioid therapy; use of methadone; monitoring of patients on chronic opioid therapy; dose escalations, high-dose opioid therapy, opioid rotation, and indications for discontinuation of therapy; prevention and management of opioid-related adverse effects; driving and work safety; identifying a medical home and when to obtain consultation; management of breakthrough pain; chronic opioid therapy in pregnancy; and opioid-related polices. Perspective: Safe and effective chronic opioid therapy for chronic noncancer pain requires clinical skills and knowledge in both the principles of opioid prescribing and on the assessment and management of risks associated with opioid abuse, addiction, and diversion. Although evidence is limited in many areas related to use of opioids for chronic noncancer pain, this guideline provides recommendations developed by a multidisciplinary expert panel following a systematic review of the evidence.

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Equianalgesic Dose Ratios for Opioids

Cited by 467 publications

References 33 publications

Oxycodone vs. Fentanyl Patient-Controlled Analgesia after Laparoscopic Cholecystectomy

Oxycodone vs. Fentanyl Patient-Controlled Analgesia after Laparoscopic Cholecystectomy

Risk factors for opioid overdose and awareness of overdose risk among veterans prescribed chronic opioids for addiction or pain

Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain

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