Effect of oxycodone patient-controlled intravenous analgesia after cesarean section: a randomized controlled study

Abstract

BackgroundOxycodone is a semisynthetic μ-opioid receptor agonist with a potentially good analgesic efficacy in visceral pain. This study aims to compare the efficacy of oxycodone with sufentanil patient-controlled intravenous analgesia (PCIA).MethodsOne hundred and twenty primiparas undergoing elective cesarean section were randomized into four groups by different drugs of PCIA: group S (sufentanil 100 μg), group OS1 (sufentanil 70 μg, oxycodone 30 mg), group OS2 (sufentanil 50 μg, oxycodone 50 mg), and group O (oxycodone 100 mg). Ramosetron 0.3 mg was added to each group. In all groups, drugs were diluted to 100 mL and managed with a continuous infusion of 1 mL·h−1, a bolus dose of 2 mL, and a lockout interval of 15 min. The maximum dose of PCIA per hour was 10 mL. After surgery, pain scores, PCIA doses, and side effects were compared among groups.ResultsAt all time points (6, 12, and 24 h after surgery), Numerical Rating Scale (NRS) of uterine cramping pain (NRS-U) scores in group O were lower than those in groups OS1 and S (P<0.008) and NRS-U scores in groups OS2 and OS1 were lower than that in group S (P<0.008). NRS of moving into the sitting position (NRS-S) scores in group O were lower than those in the other groups (P<0.008). NRS-S scores in group OS2 were lower than those in groups OS1 and S (P<0.008). At 12 and 24 h after surgery, NRS of incision pain at rest (NRS-R) scores in group O were lower than those in the other groups (P<0.008). At all time points, NRS-R scores in group OS2 were lower than those in groups OS1 and S (P<0.008). The number of PCIA boluses and amount of opioid consumption in group O were lower than those in groups OS1 and S at all time points (P<0.008).ConclusionOxycodone PCIA may be more effective than sufentanil PCIA for pain relief after cesarean section but the incidence of side effects needs further investigation.

Intravenous oxycodone compared to morphine for post-operative opioid-related adverse events in opioid naïve patients: a prospective randomized controlled trial

“…In conclusion, for clinical purposes, oxycodone or morphine can be used as first-line i. Total dose of study drug (mg) 22 19 [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] 0.048…”

“…This rate appeared to be low but probably related to the systematic prevention of nausea used in this study (see method). With oxycodone, the incidence of PONV in the literature vary according to doserelated studies and route of administration (p.o., i.v., s.c…) [15][16][17][18][19]23]. In fact, no study appears to ultimately demonstrate superiority to oxycodone vs morphine.…”

“…However, since the 1990s, oxycodone has been proposed as an alternative to morphine, because by acting on the µ1-receptors and on the κ-2-opioid agonist, it leads to a better anti nociceptive effect for post-operative pain relief or cancer-related pain [8][9][10][11][12][13][14]. Oral studies have shown that oxycodone was associated with better pain control, less serious opioid-related adverse events (ORAEs) and a faster onset of action due to a better pharmacokinetic profile: higher oral bioavailability and lower plasma variability [15][16][17][18][19]. However, controversies have arisen as a result of recent clinical studies and meta-analysis that have shown that oxycodone does not reduce adverse events and pain relief, not to mention that appetite for oxycodone itself is decreasing, due to concerns about addiction and the bad reputation that this drug has acquired in opiate-related crises [11,13,14,[19][20][21][22][23].…”

Brain-Derived Extracellular Vesicle microRNA Signatures Associated with In Utero and Postnatal Oxycodone Exposure

“…The paradigm of prenatal opioid exposure, whether the opioid is morphine, buprenorphine, or oxycodone, etc., is well established in the literature. Oxycodone as a postoperative analgesic has been reported in the literature for postpartum pain or caesarian sections in lieu of morphine drips [26,27]. The PNO group is representative of the human scenario in which a mother undergoes a caesarean section and is prescribed oxycodone for postpartum pain.…”

Intravenous oxycodone compared to morphine for post-operative opioid-related adverse events in opioid naïve patients: a prospective randomized controlled trial

“…Several studies have shown that per os oxycodone was associated with better pain control, less serious opioid-related adverse events (ORAEs) and a faster onset of action due to a better pharmacokinetic profile: higher oral bioavailability and lower plasma variability [15][16][17][18][19]. However, controversies have arisen as a result of recent clinical studies and meta-analysis that have shown that per os oxycodone did not reduce adverse events and pain relief.…”