Effect Of Oxycodone Versus Fentanyl For Intravenous Patient-controlled Analgesia After Gastrointestinal Laparotomy

ObjectivesIt 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 versus fentanyl,and the adequate potency ratio of oxycodone and fentanyl in patients with intravenous patient-controlled analgesia(IV-PCA)after gastrointestinal laparotomy.MethodsIn this double-blinded,randomized,controlled study,sixty patients undergoing elective gastrointestinal laparotomy were were randomly divided into two groups received either oxycodone or fentanyl for postoperative i.v.PCA: oxycodone(0.7mg·kg-1 oxycodone,180 mg of ketorolac)and fentanyl group(12 mg·kg-1 fentany,180 mg of ketorolac)(potency ratio 60:1).The patients received ketorolac 60 mg before the end of anesthesia and then continued with patient-controlled analgesia for48 h post-surgery.Pain severity,side effects and respiration rate(RR)were recorded30 minutes,3,6,12,24 and 48 hours after the surgery.Cumulative opioid requirements and patient satisfaction were also measured.ResultsThe median consumption over 48 h 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)(potency ratio 62.5:1),and the percentage of patients requiring rescue medication was not statistically significant(3(11.1%)vs 5(17.2%),P = 0.79).Numeric rating scores(NRS)at rest and upon movement were significantly lower in group O than in Group F(P < 0.05).The percentage of patients experienced adverse events were higher in the oxycodone group compared with the fentanyl group(33.3% vs 27.6%),but no statistically significant differences between the two groups were observed regarding the occurrence of adverse events(P = 0.64).ConclusionOur data suggest that oxycodone IV-PCA was more advantageous than fentanylIV-PCA for gastrointestinal laparotomy in view of pain control Although the occurrence of adverse events and patient satisfaction was not good in the group O compared to group F,oxycodone may be a good alternative to fentanyl in postoperative pain management.