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

Park, Joong Ho; Lee, Chiu; Shin, Youngmin; An, Jee Hyun; Ban, Jong Seouk; Lee, Ji‐Hyang

doi:10.4097/kjae.2015.68.2.153

Cited by 40 publications

(82 citation statements)

References 21 publications

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“…[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. [21] Overall, the potency ratio of fentanyl to morphine has a range of 60–100:1. After conducting a series of pilot study, we originally performed this study under the hypothesis that the potency ratio of oxycodone to fentanyl was 60:1.…”

Section: Discussionmentioning

confidence: 99%

“…First, it has been demonstrated that oxycodone produced similar or less sedation compared to fentanyl in several recent studies. [18,20,21] In addition, median doses of opioid consumed 30 minutes postsurgery was oxycodone 3.5 mg (range: 2.4–5.4 mg) and fentanyl 64 μg (range: 49–120 μg), this meant to be relatively few oxycodone consumption during this time period.…”

Section: Discussionmentioning

confidence: 99%

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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%

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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“…Despite being most frequently used orally, in recent years, its intravenous use has increased. Its potency is about 1/75 of fentanyl, and in some studies has shown great potency up to 1/60 [48,49].…”

Section: Oxycodonementioning

confidence: 99%

Patient-Controlled Analgesia (PCA) in Acute Pain: Pharmacological and Clinical Aspects

Fernandes¹,

Hernandes²,

Almeida³

et al. 2017

Pain Relief - From Analgesics to Alternative Therapies

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Moderate or severe pain are important sources of complications as well as morbidity and mortality in the postoperative period after surgical procedures. Patient-controlled analgesia (PCA) is an efective strategy for postoperative analgesia, since it may provide suitable analgesic dose just after system activation, with reduced periods of pain and an increase in patients' satisfaction. Although intravenous and epidural routes are the typical approaches used for PCA, regional patient-controlled analgesia has been shown to be an efective alternative providing a higher standard of analgesia with lower incidence of adverse efects. New devices and routes of PCA administration (transdermal, sublingual, inhalation, and oral routes) have shown to be promising alternatives in clinical studies. Nowadays, there is still no consensus regarding which is the best route or drug used since clinical eicacy/safety depends on the complex comprehension of the drugs pharmacokinetic proile through different routes of administration. Additionally, pharmacoeconomic studies are needed to evaluate the cost-efectiveness of these approaches.

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“…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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Comparison of oxycodone and fentanyl for postoperative patient-controlled analgesia after laparoscopic gynecological surgery

Cited by 40 publications

References 21 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

Patient-Controlled Analgesia (PCA) in Acute Pain: Pharmacological and Clinical Aspects

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

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