Oxycodone and sufentanil in patient-controlled intravenous analgesia following gynecological tumor operation

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Created On: 14/06/2020

Oxycodone and sufentanil in patient-controlled intravenous analgesia following gynecological tumor operation

This randomized, double-blind research is based on comparison of oxycodone and sufentanil in terms of pain relief and side effects associated with transition analgesia and PCIA following gynecological (gynae) tumor surgery.

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Key take away

Gynecological tumor surgery often causes acute postoperative pain, lengthy hospital stays, along with poor patient satisfaction. Sufentanil patient-controlled intravenous analgesia (PCIA) by the means of background infusion and oxycodone PCIA minus the background infusion was used in this study which revealed no disparity in rescue analgesia rate in post-anesthesia care unit in all the 4 groups. Also, oxycodone produced less adverse issues and lesser opioid use than sufentanil.

Background

Method

The patients undertaking the elective gynae tumor surgery were randomized into 4 groups as:

Group S: Sufentanil transition analgesia plus sufentanil PCIA,
Group OS: Oxycodone transition analgesia plus sufentanil PCIA,
Group SO: Sufentanil transition analgesia plus oxycodone PCIA and,
Group O: Oxycodone transition analgesia plus oxycodone PCIA

The Numerical Rating Scale (NRS) at rest and coughing, opioid use during PCIA and patients’ satisfaction were regarded as primary outcomes

Result

After the surgery, Group OS and Group O patients had a shorter duration of consciousness recovery (3.65 ± 2.51 p<0.0083, Group OS vs. Group SO and 3.82 ± 2.67) and extubation (5.24 ± 3.02 p<0.0083, Group OS vs. Group SO and 5.35 ± 2.94 ). Opioid use in PCIA (morphine equivalents) in Group SO and Group O was notably less [7 (3.5,12) and 7 (0,16)] in comparison with Group S and Group OS [120 (110,136) p<0.0083, Group OS vs. Group SO; p<0.0083, Group S vs. Group O and 126 (116,140) p<0.0083, Group OS vs. Group SO; p<0.0083, Group OS vs. O]. At rest and coughing, lower NRS and more patient’ satisfaction at 3 hours, 1 day and 2 days was observed in Group O patients. Shorter intestinal recovery time was observed in Group SO and group O patients.

Conclusion

Both the opioid medications, oxycodone and sufentanil offered suitable pain relief in transitional analgesia and PCIA treatment after surgery. Less analgesic drug use and quicker recovery was observed in oxycodone without background infusion as compared to sufentanil by using background infusion in PCIA following gyne tumor operation under anesthesia.