Revisiting Oxycodone Analgesia

Ruan, Xiulu; Mancuso, Ken F.; Kaye, Alan D.

doi:10.1016/j.anclin.2017.01.022

Cited by 27 publications

(26 citation statements)

References 75 publications

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“…The main site of analgesic action of oxycodone is in the central nervous system (CNS), the brain and the spinal cord. Oxycodone may also have some peripheral action that can contribute to analgesia, particularly in inflammatory and visceral pain conditions [22]. Pharmacokinetic/pharmacodynamic (PK/PD) models evaluating oxycodone analgesia in experimental visceral pain indicate a peripheral effect and show a direct linear drug-effect correlation between the plasma oxycodone concentration and visceral pain tolerance [23,24].…”

Section: Central Nervous System Penetrationmentioning

confidence: 99%

Updated Clinical Pharmacokinetics and Pharmacodynamics of Oxycodone

et al. 2019

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Global oxycodone consumption has increased sharply during the last two decades, and, in 2008, oxycodone consumption surpassed that of morphine. As oxycodone was synthesized in 1916 and taken to clinical use a year later, it has not undergone the same approval process required by today's standards. Most of the basic oxycodone pharmacokinetic (PK) data are from the 1990s and from academic research; however, a lot of additional data have been published over the last 10 years. In this review, we describe the latest oxycodone data on special populations, including neonates, children, pregnant and lactating women, and the elderly. A lot of important drug interaction data have been published that must also be taken into account when oxycodone is used concomitantly with cytochrome P450 (CYP) 3A inducers and inhibitors and/or CYP2D6 inhibitors. In addition, we gathered data on abuse-deterrent oxycodone formulations, and the PK of alternate administration routes, i.e. transmucosal and epidural, are also described. Mari Kinnunen and Panu Piirainen contributed equally to this work.

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Section: Central Nervous System Penetrationmentioning

confidence: 99%

Updated Clinical Pharmacokinetics and Pharmacodynamics of Oxycodone

et al. 2019

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“…It may have an analgesic mechanism explanation. Several recent studies have suggested that oxycodone attenuates visceral pain better than other opioids [4,18,19]. Oxycodone has a proposed effect at the κ-opioid receptor, that is a different pharmacological profile from other opioids.…”

Section: Analgesic Efficacymentioning

confidence: 99%

“…Experiments in rodents suggest that oxycodone also has an effect at the κ-opioid receptor, which in visceral nervous system was believed to inhibit visceral pain [3]. In animal experiments and clinical observations have shown that oxycodone may occasionally be superior to, e.g., morphine and fentanyl in the treatment of visceral pain [4]. However, by utilizing a meta-analysis, one can detect treatment effects with greater power and estimate these effects with greater precision [5].…”

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confidence: 99%

Oxycodone versus other opioids analgesia after laparoscopic surgery: a meta-analysis

Yang

et al. 2019

Preprint

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Background: Intravenous opioids are administered for management of visceral pain after laparoscopic surgery. Whether oxycodone has an advantage over other opioids in the treatment of visceral pain is not yet clear. Methods: This article evaluates the analgesic efficiency and adverse events of oxycodone and other opioids including alfentany, sufentanyl, fentanyl and morphine for the treatment of post laparoscopic surgery visceral pain. This review was conducted according to the methodological standards described in the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. The PubMed, Embase and Cochrane libraries were searched in December 2018. Results: Ten studies were included in this review. The sample size was 815 participants. The results showed that compared with morphine and fentanyl, oxycodone had a more potent analgesic efficacy at the first day after laparoscopic surgery, especially during the first 0.5h. There was no significant difference in sedation between the two groups. Compared to morphine and fentanyl, oxycodone was more likely to increase the risk of dizziness and drowsiness. The overall patients satisfaction had no significant difference between oxycodone versus other opioids. Conclusions: Oxycodone is a superior analgesic within 24h after laparoscopic surgery with careful regards to its adverse effects.

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“…Oxycodone is a widely used opioid which exerts its analgesic effect through both µ-and κ-opioid receptors [5,6]. In recent decades, intravenous oxycodone has been used for perioperative pain management [7].…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of intravenous oxycodone in geriatric patients undergoing general anesthesia for ophthalmic surgeries:a randomized controlled trial

Yao

et al. 2019

Preprint

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BackgroundThe present study aimed to compare the safety and efficacy of intravenous oxycodone with fentanyl in geriatric patients undergoing general anesthesia for ophthalmic surgeries.Methods107 geriatric patients (age 65-79 years old) with the ASA physical status 1 or 2 undergoing general anesthesia for glaucoma or retina surgeries between May 2016 and November 2017 were divided into three groups: Group O1, Group O2, and Group F. After exclusion, 105 patients were included for the final analysis, with 35 patients in each group. Oxycodone (0.1 mg/kg in Group O1, or 0.2 mg/kg in Group O2) or fentanyl (2 mcg/kg in Group F) was administered intravenously during induction of general anesthesia. Patient demographics, surgical time and anesthesia time, perioperative hemodynamic parameters and requirement of vasoactive medication, postoperative pain and requirement of rescue analgesics, postoperative sedation level and recovery time, and perioperative complications were recorded.ResultsPatients in Group O1 experienced less clinically significant hypotension compared to either Group F or Group O2. Consistently, patients in Group O1 required less intraoperative vasoactive medication (ephedrine) than those in Group F. The postoperative pain on extubation was more severe and more patients required rescue analgesia in Group F compared to Group O2, but not Group O1. The recovery time was longer and sedation level was higher in Group O2 than Group F or O1. The incidence of hypoxia during postoperative recovery was higher in Group O2 than Group F or O1.ConclusionOxycodone at 0.1mg/kg can be a safe and effective application for geriatric patients undergoing general anesthesia for ophthalmic surgeries, with adequate pain control and less side effects.

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Revisiting Oxycodone Analgesia

Cited by 27 publications

References 75 publications

Updated Clinical Pharmacokinetics and Pharmacodynamics of Oxycodone

Updated Clinical Pharmacokinetics and Pharmacodynamics of Oxycodone

Oxycodone versus other opioids analgesia after laparoscopic surgery: a meta-analysis

Safety and efficacy of intravenous oxycodone in geriatric patients undergoing general anesthesia for ophthalmic surgeries:a randomized controlled trial

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