Oxycodone vs. Fentanyl Patient-Controlled Analgesia after Laparoscopic Cholecystectomy

Hwang, Boo-Young; Kwon, Jae‐Young; Kim, Eun-Soo; Lee, Do-Won; Kim, Taekyun; Kim, Hae-Kyu

doi:10.7150/ijms.8331

Cited by 59 publications

(117 citation statements)

References 18 publications

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“…In a subsequent study in patients scheduled for laparoscopic cholecystectomy, IV-PCA oxycodone provided comparable effects for pain relief compared to IV-PCA fentanyl in a potency ratio of 1:75. [19] In a study of 60 laparoscopic hysterectomy, patients were randomized to receive PCA oxycodone or PCA fentanyl (potency ratio 100:1) following surgery find that oxycodone presented a better analgesic effect, also resulted in a higher occurrence of postoperative nausea and vomiting. [20] In another recent similar study, the potency ratio was 60:1, and both agents were found to provide similar analgesic efficacy and similar rates of adverse events.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and tolerability of oxycodone versus fentanyl for intravenous patient-controlled analgesia after gastrointestinal laparotomy

Ding

Wang

et al. 2016

Medicine

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Background:It has been suggested that oxycodone is effective in relieving acute postoperative pain. The aim of this study was to investigate the efficacy and tolerability of oxycodone (O) versus fentanyl (F), and the adequate potency ratio of oxycodone and fentanyl in patients with intravenous patient-controlled analgesia after gastric laparotomy.Methods:In this double-blinded, randomized, controlled study, 60 patients undergoing elective gastric laparotomy were allocated to receive either oxycodone or fentanyl for postoperative intravenous patient-controlled analgesia (potency ratio 60:1). The patients received ketorolac 60 mg before the end of anesthesia and then continued with patient-controlled analgesia for 48 hours postsurgery. Pain severity, side effects and respiration rate were recorded 30 minutes, 3, 6, 12, 24, and 48 hours after the surgery. Cumulative opioid requirements and patient satisfaction were also measured.Results:The median consumption more than 48 hours after operation of oxycodone was 50 mg (range: 40.0–62.4 mg) and fentanyl was 0.8 mg (range: 0.6–1.1 mg), and the percentage of patients requiring rescue medication was not statistically significant. Numeric rating scores at rest and upon movement were significantly lower in group O than in F (P < 0.05). Whereas the incidences of adverse events were similar between the groups (33.3% vs 27.6%, P = 0.64), a significant higher sedation scores were found in patients given fentanyl at 30 minutes after the surgery (P = 0.04).Conclusion:Oxycodone was comparable to fentanyl in the relief of postoperative pain following gastric laparotomy. Oxycodone not only provides better postoperative pain relief and less sedation, but also there was a tendency toward more side effects with oxycodone.

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Section: Discussionmentioning

confidence: 99%

Efficacy and tolerability of oxycodone versus fentanyl for intravenous patient-controlled analgesia after gastrointestinal laparotomy

Ding

Wang

et al. 2016

Medicine

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“…The pain score was evaluated with an 11-point numerical rating scale (0=no pain, 10=the worst imaginable pain). Patients were asked to rank their satisfaction with postoperative pain management at 24 and 48 hours after the initial thoracic paravertebral levobupivacaine injection according to the following scale: 1=very unsatisfactory, 2=unsatisfactory, 3=neutral, 4=satisfactory, and 5=very satisfactory 14. The records of postoperative fentanyl consumption were extracted from the internal memory of the CADD-Solis Ambulatory Infusion Pump and managed with the CADD-Solis Medication Safety Software (Smiths Medical).…”

Section: Methodsmentioning

confidence: 99%

Effects of programmed intermittent thoracic paravertebral bolus of levobupivacaine on the spread of sensory block: a randomized, controlled, double-blind study

Hida

Murata

Ichinomiya

et al. 2019

Regional Anesthesia &Amp; Pain Medicine

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Background and objectives This randomized, controlled, double-blind trial compared the effectiveness of levobupivacaine delivery of a programmed intermittent paravertebral bolus with a continuous paravertebral infusion. Methods Thirty-two consecutively enrolled patients who underwent unilateral video-assisted thoracic surgery were randomized to receive either a programmed intermittent paravertebral bolus of 10 mL of 0.2% levobupivacaine every 2 hours (Bolus group, n=16) or a continuous paravertebral infusion of 0.2% levobupivacaine at 5 mL/hour (Infusion group, n=16) after the operation. Postoperatively, after injection of 20 mL of 0.25% levobupivacaine through the paravertebral catheter, a mechanical infusion pump was set depending on the assigned group. The primary efficacy outcome was the number of anesthetized dermatomes 24 hours after the initial bolus of levobupivacaine. The secondary efficacy outcomes included the number of anesthetized dermatomes at other time points, pain at rest and coughing, additional analgesic use and patient acceptance of the analgesic technique. Arterial levobupivacaine concentration was measured to ensure safety. P<0.05 was considered statistically significant. Results The mean (95% CI) number of anesthetized dermatomes 24 hours after the initial bolus of levobupivacaine was significantly larger among subjects receiving programmed intermittent bolus (n=16) compared with those receiving continuous infusion (n=16; 6.8 (5.7–7.9) vs 3.1 (2.0–4.2); p<0.001). The arterial levobupivacaine concentration did not reach a toxic level. Conclusions The programmed intermittent paravertebral bolus of levobupivacaine provided a wider dermatomal spread of sensory block than continuous paravertebral infusion with an identical hourly dose of levobupivacaine. Trial registration number NCT000022532.

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“…However, there is significant debate regarding the equipotent ratio of fentanyl to oxycodone. Hwang et al [19] reported that the potency ratio was 1:75 in laparoscopic cholecystectomy, and oxycodone showed comparable effects for pain relief compared to fentnayl in spite of a smaller cumulative PCA dose. In other recent studies, the potency ratio of fentanyl and oxycodone was found to be 1:62.5 in gastrointestinal laparotomy, 1:60 in laparoscopic benign gynecological surgery, and 1:55 in colorectal surgery, and oxycodone was shown to provide similar analgesic efficacy to that of fentanyl [20][21][22].…”

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 Patient-Controlled Analgesia after Laparoscopic Cholecystectomy

Cited by 59 publications

References 18 publications

Efficacy and tolerability of oxycodone versus fentanyl for intravenous patient-controlled analgesia after gastrointestinal laparotomy

Efficacy and tolerability of oxycodone versus fentanyl for intravenous patient-controlled analgesia after gastrointestinal laparotomy

Effects of programmed intermittent thoracic paravertebral bolus of levobupivacaine on the spread of sensory block: a randomized, controlled, double-blind study

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

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