Oxycodone versus sufentanil in adult patient-controlled intravenous analgesia after abdominal surgery

Abstract

Background:A randomized controlled trial was performed to compare analgesic effects and adverse effects of oxycodone and sufentanil in patient-controlled intravenous analgesia (PCIA) after abdominal surgery under general anesthesia.Methods:Adult patients undergoing elective abdominal surgery were randomly allocated into oxycodone and sufentanil groups according to the randomization sequence. Study personnel, health-care team members, and patients were masked to the group assignment throughout the study period. Oxycodone (0.1 mg/kg for endoscopy; 0.15 mg/kg for laparotomy) or sufentanil (0.1 μg/kg for endoscopy; 0.15 μg/kg for laparotomy) was administrated at the end of surgeries. Postoperative pain was controlled using PCIA. Bolus dose was 2 mg and 2 μg for oxycodone and sufentanil group, respectively. The lockout time was 5 minutes for all patients, and there was no background infusion for oxycodone group, whereas 0.02 μg/kg/h background infusion was administrated in sufentanil group. The primary outcomes were the total analgesic doses in PCIA, effective bolus times, the length of first bolus since patients returning to ward from postanesthesia care unit (PACU), rescue analgesic rate in PACU, numeric rating scales, functional activity scores, and patients’ satisfaction scores.Results:A total of 200 patients were screened, and 175 patients were enrolled. Patients were randomly assigned to oxycodone (n = 87) and sufentanil (n = 88) groups. Both oxycodone and sufentanil PCIA provided adequate postoperative pain relief. Patients in oxycodone group showed a shorter consciousness recovery time after surgery. The major adverse effect in patients from oxycodone group was nausea/vomiting, whereas multiple adverse complications including nausea/vomiting, pruritus, and respiratory depression were observed in patients from sufentanil group. Patients from oxycodone group showed significantly reduced analgesic drug consumption (calculated as equivalent dose of morphine), functional activity scores, and patient satisfaction scores.Discussion:Compared with sufentanil PCIA, oxycodone PCIA showed better analgesic effects, lower incidence of adverse complications, and less analgesic drug consumption during postoperative pain management.

Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review

“…However, Han et al . 68 did not find a difference in the incidence of PONV when IV oxycodone was compared to IV sufentanil in the PACU, but on the post-surgical wards a higher incidence of PONV was found in patients receiving sufentanil 69 . The use of long-acting opioid analgesic techniques like intrathecal morphine or modified-release oral opioids not only prolongs the duration of analgesia but also can extend the duration of PONV 70 – 72 .…”

Comparison of Oxycodone and Sufentanil for intravenous patient-controlled analgesia after hip surgery: a prospective, randomized controlled trial

“…Another way to provide analgesia with decreased side effects is application of other medications. Oxycodone has been reported to be associated with lower incidence of PONV than sufentanil in different clinical setting [16,17], so we hypothesize that oxycodone PCA can provide a non-inferior effect of analgesia as the equipotency dose of sufentanil but with decreased incidence of adverse reactions in patients undergoing hip surgery.…”

<p>Oxycodone vs Sufentanil in Patient-Controlled Intravenous Analgesia After Gynecological Tumor Operation: A Randomized Double-Blind Clinical Trial</p>

“…Patients in four groups did not show any difference in rescues analgesia rate in PACU, indicating both oxycodone and sufentanil can provide satisfied transition analgesia, which was consistent with previous studies. 24,25 However, patients administrated with oxycodone showed relatively shorter time of consciousness recovery and extubation, less incidence rate of PONV, and none occurring of respiratory depression in PACU, demonstrating that, under the similar transitional analgesic effects, oxycodone induced less adverse complications when compared with sufentanil after administration of equal effect does. One possible explanation is the different metabolic productions between sufentanil and oxycodone.…”