<p>Comparison of Analgesic and Adverse Effects of Oxycodone- and Fentanyl-Based Patient-Controlled Analgesia in Patients Undergoing Robot-Assisted Laparoscopic Gastrectomy Using a 55:1 Potency Ratio of Oxycodone to Fentanyl: A Retrospective Study</p>

Abstract

Oxycodone has affinities for both kappa-and mu-opioid receptors. Therefore, it has been used for postoperative analgesia of surgeries in which visceral pain is expected to be the main cause of pain. However, there are few studies of the 55:1 potency ratio of oxycodone to fentanyl when using it as intravenous patient-controlled analgesia (IV-PCA). Thus, we compared the analgesic and adverse effects of IV-PCA using the 55:1 potency ratio of oxycodone to fentanyl in patients who underwent robot-assisted laparoscopic gastrectomy. Patients and Methods: This retrospective study included 100 patients using an automatic PCA pump with oxycodone or fentanyl who underwent robot-assisted laparoscopic gastrectomy between January and November 2017. All patients were provided with an IV-PCA consisting of 20 μg/kg of fentanyl or 1.1 mg/kg of oxycodone mixed with 0.9% normal saline solution to a total volume of 250 mL, which was infused basally at a rate of 0.1 mL/h with a bolus dose of 1 mL and lockout time of 6 min. The primary and secondary endpoints were to evaluate the efficacies of IV-PCA using the 55:1 potency ratio of oxycodone to fentanyl on analgesic and adverse effects. Results: Pain intensity on arrival at the post-anesthesia care unit (PACU; 3.6±1.4 vs 4.4±2.0, P=0.031) and additional analgesic requirement within an hour after surgery (including the PACU period) (12% vs 37%; P=0.005) were significantly lower in the oxycodone group (n=49) than in the fentanyl group (n=51). Regarding adverse effects, the rate of postoperative nausea within 1 h after surgery (2% vs 16%; P=0.031) was also significantly lower in the oxycodone group than that in the fentanyl group. Conclusion: Oxycodone-based IV-PCA by dose calculations with a 55:1 potency ratio may achieve better analgesia without any significant adverse effects, when using IV-PCA in patients undergoing robot-assisted laparoscopic gastrectomy.

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

“…Regarding adverse effects, this study results are consistent with previous research findings. Koh et al also reported that the rate of post-operative nausea within 1 h after surgery was also significantly lower in the oxycodone group than that in the fentanyl group (15). Wang et al also reported that the incidences of side effects were comparable between the two groups (16).…”

The optimal dose of oxycodone in PCIA after laparoscopic surgery for gastrointestinal cancer in elderly patients: A randomized controlled trial

“…κ-opioid receptor plays an important role in the mediation of visceral pain (6). Oxycodone, a dual agonist of μ and κ receptors (14), has been shown to provide effective analgesia for acute postoperative pain (15,16), especially visceral pain. However, the safe and effective dose of oxycodone in PCIA following laparoscopic surgery for gastrointestinal cancer in elderly patients has not been determined.…”

The effects of fentanyl, oxycodone, and butorphanol on gastrointestinal function in patients undergoing laparoscopic hysterectomy: a prospective, double-blind, randomized controlled trial

“…Because fentanyl is one of the most widely used opioids for intravenous patientcontrolled analgesia (IV-PCA) and has fewer side effects [11][12][13][14]. Previous studies have shown a fentanyl-tooxycodone conversion ratio of 1:55-100 [15,16]. However, when the fentanyl-oxycodone ratio is ≥ 1:80, most patients cannot tolerate the high incidence of nausea and vomit so analgesia therapy is always interrupted [13,15].…”