Preemptive Anti–Stress Response Effects of Oxycodone Versus Sufentanil for Patients Undergoing Cardiac Valve Replacement—A Randomized Controlled Trial

Zhang, Jian; Tu, Qing; Gan, Jianhui; Miao, Shuai; Zhou, Ying; Li, Qiang; Zheng, Chuandong

doi:10.1002/cpdd.764

Cited by 4 publications

(3 citation statements)

References 34 publications

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“…Administration of local anesthetics can reduce gastrointestinal motility, thereby reducing the risk of PONV. [62][63][64] However, this study found that there was no significant difference between bupivacaine and oxycodone on cortisol levels. In other hand, bupivacaine and oxycodone are equally effective.…”

contrasting

confidence: 54%

The Comparison of Plasma Cortisol Levels between 0.125% Bupivacaine and 5 mg Continuous Oxycodone in Lower Extremity Orthopedic Surgery

Zulkifli

Haloho

Legiran

et al. 2022

JACR

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Introduction: Pain is a problem often encountered in postoperative patients. Study has shown after a procedure, 80% patients experience acute pain. This postoperative pain will affect patient’s quality of life therefore necessitating quick and proper treatment. Tissue trauma during surgery will have influence on body system, including endocrine. One of endocrine system response is cortisol secretion. Cortisol levels may be attenuated by bupivacaine and oxycodone. The aim of this study was to determine the efficacy of bupivacaine0,125% and oxycodone 5 mg on pain perception measured by cortisol in patients undergoing orthopedic surgery of the lower limb. Methods: A randomized clinical trial, double-blind study was performed at Mohammad Hoesin General Hospital in Palembang, South Sumatra, from November to May 2021. There were forty samples and divided into two groups (bupivacaine 0,125% and oxycodone 5 mg). Groups were divided by block randomization by computerized random number generator. Blinding were done by making analgesic has the same packages to prevent knowledge of which intervention is being done. Data were analyzed using independent t-test, ANOVA, Mann-Whitney and Chi Square with SPSS version 22.0. Results: There were no statistically significant differences between the two groups on age, gender, body mass index and duration of surgery. In bupivacaine group, cortisol level decreased from 12.94±6.99 µg/dl to 11.32±5.42 µg/dl meanwhile oxycodone group cortisol levels increased from 11.81±8.47 µg/dl to 11.82±7.56 µg/dl. There were no significant difference between two groups relating to cortisol levels. Conclusions: No significant difference was found on administration of bupivacaine 0,125% and oxycodone 5 mg as epidural analgesia on cortisol level in postoperative orthopedic surgery of the lower limb patient.

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confidence: 54%

The Comparison of Plasma Cortisol Levels between 0.125% Bupivacaine and 5 mg Continuous Oxycodone in Lower Extremity Orthopedic Surgery

Zulkifli

Haloho

Legiran

et al. 2022

JACR

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“…External stimuli can excite the body’s sympathetic nerves, causing the secretion of catecholamines in the body, resulting in increases in plasma dopamine, epinephrine, and norepinephrine [ 22 , 23 ]. We found that during LMA insertion, norepinephrine was significantly increased in group B.…”

Section: Discussionmentioning

confidence: 99%

Determination of the median effective dose of sufentanil for inhibiting the laryngeal mask insertion response in geriatric patients: a prospective, double-blinded, dose–response trial

Wang

Xiao

et al. 2022

BMC Anesthesiol

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Background Laryngeal mask airway(LMA) have been widely used in clinical practice. Irritation to the patient during the insertion of a laryngeal mask can cause hemodynamic fluctuations, which is particularly unsafe for geriatric patients. We used probit regression analysis to determine the median effective dose of sufentanil to inhibit the response to LMA insertion in geriatric patients. Methods A total of 90 patients were selected for the study using the following inclusion criteria: age ≥ 65 years old, ASA grade I–III, and scheduled to undergo intravenous general anesthesia with LMA insertion. Each patient received a dose of sufentanil for anesthesia induction in one of six levels: 0.05, 0.1, 0.15, 0.2, 0.25, or 0.3 μg kg−1. LMA insertion was scored with a 3-point, 6-category scale, with scores ≥ 16 indicating effective LMA insertion, and < 16 indicating ineffective LMA insertion. Mean arterial blood pressure (MAP), heart rate (HR), and bispectral index (BIS) were recorded 1 min before induction (T1), 1 min after induction (T2), 1 min after LMA insertion (T3), and 5 min after LMA insertion (T4) in each group. In addition, the plasma norepinephrine (NE) levels and adverse reactions were measured at T2 and T3 in each dosage group. Results Probit regression analysis showed that the ED50 of sufentanil inhibiting the response to LMA insertion in geriatric patients was 0.18 μg kg−1 (95% CI: 0.16–0.21 μg kg−1), and the ED95 was 0.31 μg kg−1 (95% CI: 0.27–0.38 μg kg−1), and the probit(p) = -2.34 + 12.90 × ln(Dose)($$\chi^{2}$$ χ 2 = 0.725, p = 0.948). Among all the patients, the number of effective LMA insertions was 57 (group A), and the number of ineffective LMA insertions was 33 (group B). The MAP, HR, and NE in group B were significantly higher than in group A at T3. Conclusions Sufentanil can effectively inhibit the patient’s response to LMA insertion, with stable hemodynamics and small stress response. The ED50 and ED95 were 0.18 μg kg−1 (95% CI: 0.16–0.21 μg kg−1) and 0.31 μg kg−1(95% CI: 0.27–0.38 μg kg−1), respectively. Trial registration This study was registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2100051827) on October 6, 2021.

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“…Cortisol secretion is one of the main features of the neuroendoctrinal metabolic response to surgery. [5][6][7] Surgical stimuli in the form of a pain response and tissue trauma will activate the central nervous system and generate a stress response through two pathways known as the "hypothalamic-pituitary and sympathetic-adrenal" axes. Preemptive analgesic oxycodone can reduce cortisol secretion.…”

Section: Discussionmentioning

confidence: 99%

Oxycodone 5 Miligram is More Effective Than Ketorolac 30 Miligram in Suppressing Cortisol Levels During General Anesthesia

Kelvin

Zainal

et al. 2021

JACR

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Background: Preemptive analgesia is a developing clinical concept, which involves administering analgesics before pain stimulation occurs, to prevent the sensitization of the nervous system to further stimuli that can cause pain. Ketorolac has strong analgesic properties oxycodone is a semisynthetic opioid that is synthesized from the alkaloid thebaine opiate. Pain could induce stress hormone such as cortisol. Study to compare ketorolac and oxycodone with cortisol has not been investigated. This study aimed to assess intravenous administration of ketorolac 30 mg compared with intravenous 5 mg oxycodone for pain as measured by cortisol levels post-intervention in surgery performed under general anesthesia. Method: A study randomized controlled trial in double-blind form for patients at dr. Mohammad Hoesin Palembang, who will undergo elective surgery with general anesthesia at the Central Surgical Installation building, with the period September-October 2020. There are 24 study samples, to anticipate dropouts, an added sample size is 10%, so the sample size is 26 for each treatment group. The selection of subjects according to the purpose of the study was carried out by simple random. Data analysis using SPSS ver 22.0 software. Data were analyzed using Independent T-Test, Mann Whitney, and Chi-Square Test. Result: The results showed, there was a significant difference in the effectiveness of intravenous administration of ketorolac 30 mg and intravenous oxycodone 5 mg on pain as measured by cortisol levels in patients undergoing general anesthesia at dr. Mohammad Hoesin Palembang (p = 0.013). The value of cortisol levels in pre- operative patients who will be given general anesthesia at dr. There was no statistically significant difference between Mohammad Hoesin in the two groups (p = 0.107). The value of cortisol levels in preoperative patients who were given ketorolac 30 mg intravenously at dr. Mohammad Hoesin was 9.90 ± 4.2. The value of cortisol levels in postoperative patients who were given ketorolac 30 mg intravenously at dr. Mohammad Hoesin was 17.75 ± 6.08. The value of preoperative cortisol levels for patients who were given oxycodone 5 mg intravenously at dr. Mohammad Hoesin was 12.03 ± 5.10. The value of postoperative cortisol levels for patients who were given oxycodone 5 mg intravenously at dr. Mohammad Hoesin is 14.50 ± 4.75. Conclusion: There was a significant difference in the effectiveness of intravenous administration of ketorolac 30 mg and oxycodone 5 mg intravenously on BSS levels (p = 0.005) and VAS scores (p = 0.001) who underwent general anesthesia at dr. Mohammad Hoesin Palembang.

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Preemptive Anti–Stress Response Effects of Oxycodone Versus Sufentanil for Patients Undergoing Cardiac Valve Replacement—A Randomized Controlled Trial

Cited by 4 publications

References 34 publications

The Comparison of Plasma Cortisol Levels between 0.125% Bupivacaine and 5 mg Continuous Oxycodone in Lower Extremity Orthopedic Surgery

The Comparison of Plasma Cortisol Levels between 0.125% Bupivacaine and 5 mg Continuous Oxycodone in Lower Extremity Orthopedic Surgery

Determination of the median effective dose of sufentanil for inhibiting the laryngeal mask insertion response in geriatric patients: a prospective, double-blinded, dose–response trial

Oxycodone 5 Miligram is More Effective Than Ketorolac 30 Miligram in Suppressing Cortisol Levels During General Anesthesia

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