The Effect of Oxycodone on Post-operative Pain and Inflammatory Cytokine Release in Elderly Patients Undergoing Laparoscopic Gastrectomy

Abstract

Background: To evaluate the effect of oxycodone on post-operative pain and inflammation in elderly patients undergoing laparoscopic gastrectomy.Methods: Sixty patients who were of both sexes, American Society of Anesthesiologists Physical Status (ASA-PS) Class I or II, over 65 years of age and undergoing an elective laparoscopic radical gastrectomy were randomly divided into two groups: an oxycodone group (Group O) including 20 males and 10 females and a sufentanil group (Group S) including 21 males and 9 females. The post-operative analgesia regimen was as follows: 40 mg of parecoxib sodium and 0.1 mg/kg of oxycodone was intravenously injected into Group O before the abdomen closure, while 40 mg of parecoxib sodium and 0.1 μg/kg of sufentanil was injected intravenously into Group S. Both groups were infiltrated with 20 ml of 1% ropivacaine at the end of the operation. The level of serum IL-6 and IL-10 were assayed immediately at the following timepoints: at the conclusion of surgery (T1), 1 h (T2), 6 h (T3), and 24 h (T4) after the completion of the surgery. The numerical rating scale (NRS), the Ramsay sedation score, analgesic-related adverse events, post-operative pulmonary inflammation events and the post-operative stay were recorded.Results: Compared with Group S, the serum IL-6 concentrations of Group O decreased at T3 and T4, while the serum IL-10 concentrations increased (P < 0.05). In Group O, the serum IL-6 concentrations at T3 and T4 were lower than those at T1 (P < 0.05). The incidence of post-operative nausea and vomiting (PONV) and pulmonary inflammation in Group O was lower than that in Group S (P < 0.05). At each time point, the NRS of visceral pain in Group O was lower than that in Group S. At 6 and 24 h after extubation, the NRS of incision pain in Group O was lower than that in Group S (P < 0.05).Conclusion: Oxycodone can regulate the level of inflammatory cytokines and reduce post-operative inflammatory response.

Ultrasound-guided transversus abdominis plane block as an effective anesthetic technique for transverse colostomy in a high-risk elderly patient: A case report

“…Oxycodone is effective to relieve visceral pain by mainly stimulating κ receptor. It was also found to be effective and efficient to regulate post-operative pain and inflammatory cytokine release in elderly patients undergoing laparoscopic gastrectomy ( 16 ). Hence, we added a small amount of oxycodone to alleviate abdominal visceral discomfort during the operation.…”

Analysis of postoperative pulmonary complications after gastrectomy for gastric cancer: development and validation of a nomogram

“…A single dose of intravenous oxycodone > 5.5 mg before the abdomen closure was an independent risk factor for PPCs in this study. While oxycodone was reported to regulate inflammatory cytokines and reduce more inflammatory response to alleviate postoperative pain compared with sufentanil (37). Low dose of oxycodone should be recommended after gastrectomy.…”

The Median Effective Concentration (EC50) of Epidural Ropivacaine With Different Doses of Oxycodone During Limb Surgery in Elderly Patients

“…Oxycodone is another kind of drug with strong analgesic effect and less adverse reactions. At present, it has been widely used in intraoperative (5) and postoperative analgesia (7). It is also be safely and effectively used in epidural anesthesia in elderly patients (8) with few studies regarding its effect on the EC 50 of epidural ropivacaine for elderly patients.…”