Oxycodone vs. fentanyl in the treatment of early post‐operative pain after laparoscopic cholecystectomy: a randomised double‐blind study

Koch, Stefanie; Ahlburg, P.; Spangsberg, N; Brock, Brigit V.; Tønnesen, Else; Nikolajsen, Lone

doi:10.1111/j.1399-6576.2008.01643.x

Cited by 67 publications

(119 citation statements)

References 13 publications

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“…Therefore, we decided to use oxycodone for postoperative pain management and PCA. In other studies, oxycodone was presumed to be more effective than fentanyl based on the currently recommended conversion factor of 1 : 100 [5]; however, we found that the direct conversion of intravenous fentanyl to intravenous oxycodone did not fall within a safe range.…”

Section: Introductioncontrasting

confidence: 51%

“…Also, Kalso et al [17] suggested that the equianalgesic dose ratio of oxycodone to morphine was 2 : 3, as calculated based on total opioid consumption during a 2-hour period. But there are no safe recommendations regarding the direct conversion factor for intravenous oxycodone and intravenous fentanyl, as compared with that for intravenous fentanyl and intravenous morphine (1 : 100) [5]. We calculated a conversion factor of 1 : 100 based on our daily clinical practice and the recommended conversion factor for intravenous fentanyl to intravenous morphine [18].…”

Section: Discussionmentioning

confidence: 99%

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A comparison of oxycodone and fentanyl in the management of early postoperative pain and for patient-controlled analgesia after total abdominal hysterectomy

2016

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background:Although oxycodone has been known to be superior to other opioids in postoperative care, few studies have compared its analgesic potency with that of fentanyl. We therefore examined these two drugs in terms of their dose requirements, effects on pain intensity, time needed for relief of pain, and side effects after surgery. Methods: We enrolled 56 healthy women scheduled for total abdominal hysterectomy and randomly allocated them to either oxycodone or fentanyl. The opioids were administered to the two groups 10 minutes before the end of the operation. In the post-anesthesia care unit (PACU) after surgery, a visual analog scale (VAS) was used to assess the patients' pain every 10 minutes Whenever pain control was required, a bolus of the same dose of the respective drugs was repeated at 10-minute intervals. Patient-controlled analgesia (PCA) was used to manage postoperative pain. After the patient arrived on the ward, pain scores were recorded at once and then 1, 2, 3, and 24 hours thereafter. Results: During the hour spent in the PACU, fewer patients in the oxycodone group required the opioid, and the time needed to achieve pain relief was shorter with oxycodone than with fentanyl. Moreover, postoperative VAS levels were significantly lower in the oxycodone group both in the PACU and on the ward (over a 24-hours period). There were no significant differences in side effects between the patients given oxycodone and those given fentanyl. Conclusions: Oxycodone was more effective than fentanyl when administered on the basis of the recommended dose ratio (1 : 100). Although further evaluation is needed to investigate the optimal dose ratio, we would recommend a higher conversion factor (1 : 62). Fentanyl is one of the most frequently used opioids for the management of acute postoperative pain and for PCA, but various studies using intravenous fentanyl for postoperative analgesia have revealed that pain scores remain high for 4 or 6 hours after surgery [3,4]. Therefore, we decided to use oxycodone for postoperative pain management and PCA. In other studies, oxycodone was presumed to be more effective than fentanyl based on the currently recommended conversion factor of 1 : 100 [5]; however, we found that the direct conversion of intravenous fentanyl to intravenous oxycodone did not fall within a safe range.We aimed to compare the analgesic efficacy of fentanyl and oxycodone in patients who had visceral postoperative pain initially in the PACU and then in the ward for 24 hours. The known equivalent potency of these two opioids was assessed based on pain scores, cumulative drug consumption, sedation scales, and side effects. In the operating room, patients were monitored by means of pulse oximetry, electroc...

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Section: Introductioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

A comparison of oxycodone and fentanyl in the management of early postoperative pain and for patient-controlled analgesia after total abdominal hysterectomy

2016

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“…Further study with multi-modal (mechanical, thermal and electrical) pain tests in the skin, muscles and viscera is needed (8,26,27). Moreover, further study can focus on optimal dose with least side effects for the treatment of the visceral pain after LC (28).…”

Section: Lc Is One Of the Most Popular Procedures Inmentioning

confidence: 99%

A Comparison of Intravenous Oxycodone and Parecoxib in the Treatment of Visceral Pain after Laparoscopic Cholecystectomy

Wang¹,

Yao²,

Wang³

et al. 2015

J Anesth Perioper Med

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“…Numerous studies have suggested that IV oxycodone is an effective treatment for acute postoperative pain [16,17]. Furthermore, determination of the proper dosage regimen of oxycodone is important for effective pain control.…”

mentioning

confidence: 99%

“…Oxycodone is an effective analgesic agent for visceral pain and somatic pain, but studies to date have shown that it is more effective for visceral pain [7][8][9]27]. Likewise, pain after abdominal surgery is controlled by similar or smaller amounts of oxycodone compared with the equipotent ratio of morphine or fentanyl [16][17][18][19][20][21][22]. Therefore, in somatic pain such as pain after orthopedic surgery, the amount of oxycodone should be higher than the dose used for visceral pain.…”

mentioning

confidence: 99%

Comparison of oxycodone and fentanyl for postoperative patient-controlled analgesia after orthopedic surgery

et al. 2018

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Background: Oxycodone is widely used as bolus or patient-controlled analgesia (PCA) for control of postoperative pain. The aim of this study was to assess the efficacy and side effects of oxycodone for somatic pain by comparing oxycodone and fentanyl intravenous PCA after orthopedic surgery.Methods: Seventy-three patients undergoing orthopedic surgery were randomly assigned to receive fentanyl or oxycodone using intravenous PCA (potency ratio 1:60). Pain severity at rest and with movement and adverse effects were assessed at 1, 6, 24, and 48 hours after surgery. The PCA dose and patient satisfaction scores were measured at 48 hours after surgery.Results: The resting visual analogue scale (VAS) and moving VAS scores of the oxycodone group were significantly higher than those of the fentanyl group at 6 hours (P = 0.001, P = 0.021), but at 48 hours, the resting and moving VAS of the oxycodone group were significantly lower than those of the fentanyl group (P = 0.014, P = 0.037). There were no significant differences in adverse effects, satisfaction scores, dose of patientcontrolled mode, or total cumulative PCA dose.Conclusions: With a 1:60 ratio of oxycodone to fentanyl when using PCA for pain control after orthopedic surgery, the use of larger doses of oxycodone for 6 hours is effective in controlling early postoperative pain.

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Oxycodone vs. fentanyl in the treatment of early post‐operative pain after laparoscopic cholecystectomy: a randomised double‐blind study

Abstract: Oxycodone provided better analgesia but also more side effects, suggesting that the doses used in the present study may not be equipotent.

Cited by 67 publications

References 13 publications

A comparison of oxycodone and fentanyl in the management of early postoperative pain and for patient-controlled analgesia after total abdominal hysterectomy

A comparison of oxycodone and fentanyl in the management of early postoperative pain and for patient-controlled analgesia after total abdominal hysterectomy

A Comparison of Intravenous Oxycodone and Parecoxib in the Treatment of Visceral Pain after Laparoscopic Cholecystectomy

Comparison of oxycodone and fentanyl for postoperative patient-controlled analgesia after orthopedic surgery

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