Oral oxycodone offers equivalent analgesia to intravenous patient-controlled analgesia after total hip replacement: a randomized, single-centre, non-blinded, non-inferiority study

Rothwell, Matt; Pearson, David; Hunter, J. D.; Mitchell, Philip; Graham-Woollard, T.; Goodwin, Lynsey; Dunn, G. L.

doi:10.1093/bja/aer084

Cited by 47 publications

(31 citation statements)

References 21 publications

(19 reference statements)

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“…20,21 At the same time, it has been shown that regularly scheduled sustained-release oxycodone administration, versus as-needed opioid analgesics, increases the rate of postoperative †OSA was determined by a history of previous diagnosis (n = 516) or positive screen for OSA during immediate preoperative assessment (n = 375). 6 ‡One patient was administered 75 mg pregabalin, which was categorized in the low-dose gabapentin category.…”

Section: Discussionmentioning

confidence: 99%

Multimodal Analgesic Protocol and Postanesthesia Respiratory Depression During Phase I Recovery After Total Joint Arthroplasty

Weingarten

Jacob

Njathi

et al. 2015

Regional Anesthesia and Pain Medicine

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Section: Discussionmentioning

confidence: 99%

Multimodal Analgesic Protocol and Postanesthesia Respiratory Depression During Phase I Recovery After Total Joint Arthroplasty

Weingarten

Jacob

Njathi

et al. 2015

Regional Anesthesia and Pain Medicine

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“…After orthopaedic surgery with postoperative opioid pain therapy, constipation was associated with a hospital stay prolonged by 1.4 days [6]. In another study, opioid-related ADEs including constipation after orthopedic surgery were associated with both hospital stay prolonged by 0.5 days and increased hospital costs [12]. …”

Section: Discussionmentioning

confidence: 99%

“…Controlled-release oxycodone formulations provide relatively constant plasma concentrations [11] and seem to be feasible options in the treatment of postoperative pain [12, 13]. Oxycodone-naloxone controlled-release tablets are increasingly used for postoperative pain in order to decrease the risk of OIC [14], and preliminary experience suggests that this combination may also decrease other opioid-induced adverse events, like urinary retention [13].…”

Section: Introductionmentioning

confidence: 99%

Opioid-Induced Bowel Dysfunction in Patients Undergoing Spine Surgery: Comparison of Oxycodone and Oxycodone-Naloxone Treatment

et al. 2016

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IntroductionOpioids are needed for postoperative pain in spine surgery patients, but opioid-induced constipation is a harmful adverse event. The aim of this clinical trial was to compare the use of a controlled-release oxycodone-naloxone combination product with oxycodone controlled-release tablets in these patients. The main outcome measure was the prevalence of constipation at 7 days postoperatively assessed with a Bowel Function Index questionnaire. A follow-up assessment at 21 days after surgery was also included.MethodsA total of 180 patients undergoing spine surgery, 91 having preoperative opioids in use and 89 opioid-naïve, were randomized to receive twice-daily oxycodone 10 mg or oxycodone-naloxone 10/5 mg controlled-release tablets for the first 7 postoperative days. Patients were followed-up for 21 days after surgery.ResultsAt baseline, prevalence of constipation was common both in the opioid-naïve—25/87 (29%) and on-opioid groups 43/90 (48%) (P = 0.009). This increased at 7 days postoperatively with no difference between the groups, 54/89 with oxycodone and 54/88 with oxycodone-naloxone had constipation. At 21 days, constipation was less than in the baseline in both groups, in the opioid-naïve group the prevalence of constipation was 3/43 (7%) in patients with oxycodone-naloxone compared to 9/44 (21%) with oxycodone (effect size 0.68; P = 0.068). Both study compounds provided similar pain relief and were well tolerated.ConclusionIn patients presented for back surgery, the prevalence of constipation was significantly higher than that in the community. In opioid-naïve subjects, oxycodone-naloxone was beneficial concerning constipation; but this was not distinguishable in subjects with chronic opioid use. The analgesic efficacy of oxycodone and oxycodone-naloxone was similar. Trial registration: European Clinical Trials Database (EudraCT no. 2012-001816-42) and ClinicalTrials.gov database (Identifier: NCT02573922).

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“…Some recent clinical trials and reviews/ meta-analyses show that oxycodone is similar in effectiveness to morphine, [61][62][63][64] and hydromorphone. [65] A recent meta-analysis of oxycodone versus other strong opioids (n=37 studies and 7 randomized clinical trials, 613 cancer patients with moderate to severe pain) found in 4 studies that oxycodone was significantly better than other strong opioids in reducing pain intensity in cancer patients and in seven studies there was a significant difference favoring oxycodone for effective pain relieve in cancer pain.…”

Section: Selecting the Right Opioid: When Can Ir Oxycodone Be A Good mentioning

confidence: 99%

Maximizing value in opioid utilization: Is oxycodone immediate release a good option for pain management?

Pergolizzi

Talu

Zmponga

et al. 2015

Agri

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ÖzetAğrı tedavisine modern yaklaşım sürecin her yönüyle optimal düzeye getirilmesinden geçer. Bu SummaryThe modern approach to the management of pain involves optimizing all aspects of the process. This includes utilization of pharmacologic and non-pharmacologic modalities, consideration of patient characteristics, proper matching of the physiology of the pain with the analgesic' s mechanism of action (pharmacodynamics, PD), and the onset and duration of action (pharmacokinetics, PK). No single agent or formulation satisfies all of the requirements for all patients. Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) are effective options for inflammatory pain and, as is acetaminophen, for mild pain. Specialized agents are helpful for particular pains, such as for migraine headache. Opioids remain the standard option for severe pain. Although they are generally a safe and effective option, opioids can produce dose-limiting adverse effects and have abuse potential. The goal of pain therapy is thus to achieve the maximum pain relief with the least amount of opioid exposure. Against this background of measured approach to the use of analgesics, an immediate release (IR) oral formulation of the established opioid oxycodone has been developed to provide rapid onset of action and rate of titration, both of which could maximize temporal matching of dose with pain level and reduce total exposure to drug. This article considers the option of an immediate release (IR) oral formulation for the management of pain.

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Oral oxycodone offers equivalent analgesia to intravenous patient-controlled analgesia after total hip replacement: a randomized, single-centre, non-blinded, non-inferiority study

Abstract: Oral analgesia with OOXY after THR offers non-inferior analgesia to IVPCA and may offer some logistical and cost advantages.

Cited by 47 publications

References 21 publications

Multimodal Analgesic Protocol and Postanesthesia Respiratory Depression During Phase I Recovery After Total Joint Arthroplasty

Multimodal Analgesic Protocol and Postanesthesia Respiratory Depression During Phase I Recovery After Total Joint Arthroplasty

Opioid-Induced Bowel Dysfunction in Patients Undergoing Spine Surgery: Comparison of Oxycodone and Oxycodone-Naloxone Treatment

Maximizing value in opioid utilization: Is oxycodone immediate release a good option for pain management?

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