Oxycodone vs. fentanyl patient-controlled analgesia after laparoscopic cholecystectomy

Abstract

Objectives: Oxycodone is semi-synthetic opioid, oral and parenteral preparations have been widely used for acute and chronic pain. The aim of this study was to assess the efficacy and side effects of oxycodone and fentanyl in patient controlled analgesia (PCA) after laparoscopic cholecystectomy.

Methods: A prospective, randomized, double-blind study was conducted. 81 patients were randomly divided into two groups; fentanyl (10 mcg fentanyl and 1.5 mg ketorolac) and oxycodone group (1 mg oxycodone and 1.5 mg ketorolac). After the operation, a blinded observer assessed pain using a numerical rating scale (NRS), infused PCA dose, side effects, sedation levels, and satisfaction.

Results: Cumulative PCA dose of oxycodone group at 48 h (31.4 ± 16.0 ml) was significantly less than that of fentanyl group (43.8 ± 23.1 ml, P = 0.009). Oxycodone group showed more nausea at 6-24 h after the operation (P = 0.001), but there was no difference in satisfaction score (P = 0.073). There were no significant differences in other side effects, sedation and NRS scores between two groups.

Conclusion: Oxycodone showed comparable effects for pain relief compared to fentanyl in spite of less cumulative PCA dose. Based on these results, we could conclude that oxycodone may be useful as an alternative to fentanyl for PCA after laparoscopic cholecystectomy.

Keywords: Fentanyl; Laparoscopic cholecystectomy surgery; Oxycodone; Patient-controlled analgesia; Postoperative pain..

Figure 1

Cumulative PCA dose measured at several time points between 1 and 48 h after the operation. The patients of fentanyl group show higher consumption rate than the patients of oxycodone group. Data are expressed as mean ± SD., *P < 0.05 and **P < 0.01 according to Mann-Whitney test.

Figure 2

Ramsey sedation scores at several time points between 1 and 48 h after the operation. Both groups show similar sedation levels. Data are expressed as mean ± SD.

Figure 3

Numerical rating scale (NRS) of pain at 1 - 48 h after the operation. The NRS of pain intensity was assessed (a) at rest and (b) during coughing. There is no significant difference between both groups. Both groups show marked decrease in pain as the time passed. Data are expressed as mean ± SD.