A Randomized, Double-Blind, Placebo-Controlled Study of Preemptive Oral Oxycodone with Morphine Patient-Controlled Anesthesia for Postoperative Pain Management in Patients Undergoing Uterine Artery Embolization for Symptomatic Uterine Fibroids

Abstract

Purpose To evaluate the analgesic efficacy of oral premedication of oxycodone in a group of patients undergoing elective uterine artery embolization under sedation for fibroid disease. Methods Thirty-nine patients (mean age 42.3 years) were prospectively randomized 1:1 to receive 20 mg oxycodone or placebo orally immediately before their procedure. At the commencement of the procedure, patients were provided with a patient-controlled analgesia device for 24 h, programmed to deliver 1 mg boluses of intravenous morphine with a 5 min lockout. Mean visual analog scale pain intensity ratings (0-100 mm) were measured from both groups and evaluated over 0 to 6 h as the primary end point. Other measured parameters included opioid-related side effects and eligibility for discharge (NCT00163930; September 12, 2005). Results Early pain intensity did not vary significantly between the active and placebo groups [mean (standard deviation): 3.2 (2.5) vs. 3.1 (2.2), p = 0.89]. The oxycodone group, however, experienced significantly more nausea (p = 0.035) and a greater incidence of vomiting (p = 0.044). Overall opioid requirement over 24 h, measured as oral morphine equivalent, was greater in the oxycodone group (median [interquartile range]: 64.5

Effect of preoperative intravenous oxycodone administration on sufentanil consumption after retroperitoneal laparoscopic nephrectomy

“…The result of this clinical trial corresponds with the previous studies that preoperative controlled-release oxycodone could decrease postoperative pain without an increase of side effects [7,8] Our results, however, are at variance with the results of Konstantatos et al They demonstrated that the addition of preprocedural oral oxycodone to morphine PCA did not offer any analgesic advantage to patients undergoing uterine artery embolization [9]. This could be ascribed to too late administration of oral oxycodone which was administered just before the procedure.…”

A comparative study on the effects of MRI- and CT-guided interventional therapies on uterine fibroids

“…Moreover, in some cases, UAE still fails to cease blood flow in the uterine artery, and embolic agents may enter the ovary and affect blood supply therein accordingly. To this end, MRI guidance is employed to shun ovarian branch of the uterine artery and to clearly display foci and the surrounding structures, thereby allowing real-time image feedback and non-axial entrance, monitoring the locations of related tissues in random directions, and minimizing injuries to normal tissues 19. In this study, the serum FSH, LH and E2 levels of the two groups were similar before treatment, which were significantly raised after treatment (P<0.05).…”

Effect of preemptive analgesia with intravenous oxycodone in the patients undergoing laparoscopic resection of ovarian tumor

“…Our results, however, are at variance with the results of Konstantatos et al They demonstrated that the addition of preprocedural oral oxycodone to morphine patient-controlled analgesia did not offer any analgesic advantage to patients undergoing uterine artery embolization. 13 This could be ascribed to too late adminstration of oral oxycodone which was administered just before the procedure. It was proposed that adequate time interval between drug administration and surgical procedure was necessary for preemptive effect of oxycodone to be exhibited.…”