Oxycodone versus other opioid analgesics after laparoscopic surgery: a meta-analysis

Abstract

Background: Intravenous opioids are administered for the management of visceral pain after laparoscopic surgery. Whether oxycodone has advantages over other opioids in the treatment of visceral pain is not yet clear.

Methods: In this study, the analgesic efficiency and adverse events of oxycodone and other opioids, including alfentanil, sufentanil, fentanyl, and morphine, in treating post-laparoscopic surgery visceral pain were evaluated. This review was conducted according to the methodological standards described in the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. The PubMed, Embase, and Cochrane databases were searched in December 2019.

Results: Ten studies were included in this review. The sample size was 695 participants. The results showed that compared with morphine and fentanyl, oxycodone had a more potent analgesic efficacy on the first day after laparoscopic surgery, especially during the first 0.5 h. There was no significant difference in sedation between the two groups. Compared to morphine and fentanyl, oxycodone was more likely to lead to dizziness and drowsiness. Overall, patient satisfaction did not differ significantly between oxycodone and other opioids.

Conclusions: Oxycodone is superior to other analgesics within 24 h after laparoscopic surgery, but its adverse effects should be carefully considered.

Keywords: Laparoscopic surgery; Meta-analysis; Oxycodone; Postoperative visceral pain.

Fig. 1

Study screening flow diagram

Fig. 2

Risk of bias of included studies

Fig. 3

Meta-analysis of pain intensity. CI confidence interval

Fig. 4

Meta-analysis of sedation score at 2 (occasionally drowsy, easily aroused). CI confidence interval

Fig. 5

Meta-analysis of adverse events. CI confidence interval

Fig. 6

Meta-analysis of patient satisfaction. CI confidence interval