Epidural Oxycodone for Acute Pain

Piirainen, Panu; Kokki, Hannu; Kokki, Merja

doi:10.3390/ph15050643

Cited by 3 publications

(4 citation statements)

References 108 publications

(156 reference statements)

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“…During gastroscopic procedures, oxycodone can effectively suppress the injurious stimuli associated with the examination, but excessive amounts of oxycodone can cause respiratory depression. [4,6,8,11,16] Postoperative cognitive dysfunction refers to changes in orientation, thinking, memory, attention, and other cognitive abilities in patients undergoing surgical anesthesia who have no preoperative psychiatric abnormalities. [17] The occurrence of postoperative cognitive dysfunction can impair recovery, prolong hospital stay and even affect the quality of life after discharge.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…[4,5] It can agonize both μ- and κ-opioid receptors and has the advantages of rapid onset of action, better analgesia, and fewer adverse effects such as respiratory depression. [4,5] Oxycodone is an optional agent for the clinical management of acute pain, [6] chronic pain, [7] postoperative pain, [5,8] cancer-related pain, [9] visceral pain, [10] osteoarthritis-related pain, [5] and neuropathic pain. [10] Researchers believe it can be used as effectively as morphine in selected patients at the doses studied, with fewer side effects.…”

Section: Introductionmentioning

confidence: 99%

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Safety and efficacy of etomidate in combination with oxycodone in painless gastroscopic procedures in the elderly: A prospective randomized controlled trial study

Zhou

2023

Medicine

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Objective: Etomidate is often combined in rapid succession during induction of anesthesia. However, the effect of pretreatment with oxycodone on recovery of cognitive function and adverse effects has rarely been studied. We conducted a prospective randomized controlled trial to compare etomidate alone with etomidate combined with oxycodone in elderly patients undergoing painless gastroscopy.Methods: Hundred elderly patients undergoing painless gastroscopy were divided into a control and an observation group, with 50 cases in each group. The age, gender, height, weight, body mass index and American Society of Anesthesiologists physical status (I/II) of patients in both groups were recorded. The recovery of cognitive function was compared in both groups using the Neurobehavioral Cognitive Status Examination. Adverse events, including somatic motor reactions, hypotension, bradycardia, myocardial tremor, nausea and vomiting, and injection pain, were also recorded in both groups. Moreover, heart rate, peripheral capillary oxygen saturation, systolic blood pressure, and diastolic blood pressure were evaluated in the 2 groups at different time points.Results: A total of 100 patients were enrolled in this study. The demographic characteristics in the 2 groups were not significantly different (P > .05). Regarding the recovery of cognitive functions, more subjects in the observation group passed the memory, arithmetic and orientation test than in the control group (P < .05). Fewer adverse events such as dynamic body reactions, cardiac tremor, nausea and vomiting, and injection pain occurred in the observation group than in the control group (P < .05). During anesthesia and after awakening, the results of peripheral capillary oxygen saturation, systolic blood pressure and diastolic blood pressure were better in the observation group than in the control group (P < .05). Conclusion:Etomidate in combination with oxycodone for painless gastroscopic operation in the elderly is a safe and effective anesthetic strategy.Abbreviations: ASA = American Society of Anesthesiologists, BMI = body mass index, DBP = diastolic blood pressure, HR = heart rate, SBP = systolic blood pressure, SpO 2 = peripheral capillary oxygen saturation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Safety and efficacy of etomidate in combination with oxycodone in painless gastroscopic procedures in the elderly: A prospective randomized controlled trial study

Zhou

2023

Medicine

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“…Some studies show that epidural administration of oxycodone has better analgetic outcomes than oxycodone given intravenously. However, its epidural administration has not been approved by the FDA [42,45,73,74].…”

Section: Oxycodonementioning

confidence: 99%

Epidural Administration - New Perspectives and Uses

2023

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First described by Fidel Pages in 1921, epidural administration is a technique in which a medicine is injected into the epidural space has undergone various modifications and approaches in recent years. Epidural administration also involves the placement of a catheter into the epidural space, which may remain in place for the duration of the treatment. These advances have changed the face of clinical practice and improved the patient management. Modification to the approach of epidural administration has moved from the single-shot epidural administration to programmed injections. The use of these improved techniques has reduced complications associated with epidural administration and improved care. The administration of medication into this space has been considered as safe and effective for providing pain relief during childbirth and surgery. A review of these modes of administration will highlight the importance of each of the techniques.

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Physiology and Pharmacology of Epidurally Administered Drugs

Brusich¹,

Valenčić²,

Polonijo³

2023

Epidural Administration - New Perspectives and Uses

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In the last few decades, epidural administration of various drugs has gained popularity and widespread clinical acceptance. Epidural administration of local anesthetics and opioids has been considered “state of the art” in acute pain management (thoracic and major abdominal surgery, labor). Its advantage is that it yields profound, long-lasting, dose-dependent analgesia, leaving other sensory and motor functions intact. It facilitates early patient mobilization and ambulation and therefore reduces the risk of postoperative thromboembolism and respiratory complications. The increment in the elderly population caused an increase in musculoskeletal and spine diseases and thus, epidural steroid injections have become highly effective for chronic pain treatment. There are many factors that have an impact on drug physiology and pharmacology in the epidural space and, therefore, can modify epidural anesthesia or the expected effect of another medication. This chapter provides insight into this complex and comprehensive topic to demonstrate a predictable pattern that can provide a safe and accurate guide to clinical practice.

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Epidural Oxycodone for Acute Pain

Cited by 3 publications

References 108 publications

Safety and efficacy of etomidate in combination with oxycodone in painless gastroscopic procedures in the elderly: A prospective randomized controlled trial study

Safety and efficacy of etomidate in combination with oxycodone in painless gastroscopic procedures in the elderly: A prospective randomized controlled trial study

Epidural Administration - New Perspectives and Uses

Physiology and Pharmacology of Epidurally Administered Drugs

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