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Oxycodone vs. fentanyl in the treatment of early post‐operative pain after laparoscopic cholecystectomy: a randomised double‐blind study
Author(s) -
KOCH S.,
AHLBURG P.,
SPANGSBERG N.,
BROCK B.,
TØNNESEN E.,
NIKOLAJSEN L.
Publication year - 2008
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2008.01643.x
Subject(s) - oxycodone , medicine , fentanyl , pacu , anesthesia , nausea , vomiting , sedation , morphine , opioid , receptor
Background: It has been suggested that oxycodone is superior to other opioids in the treatment of visceral pain. We therefore compared the effect of intravenous (i.v.) oxycodone and i.v. fentanyl on post‐operative abdominal (visceral) pain after outpatient laparoscopic cholecystectomy. Methods: Seventy‐eight patients were randomised to intra‐ and post‐operative pain treatment with either oxycodone ( n =39) or fentanyl ( n =39). The patients received 10 mg oxycodone/100 μg fentanyl at the end of anaesthesia. In the post‐anaesthetic care unit (PACU), 5 mg oxycodone/50 μg fentanyl was administered to patients with moderate pain [3–5 on a numeric rating scale (NRS)], and 10 mg oxycodone/100 μg fentanyl was administered to patients with severe pain (>5 on an NRS). The following measures were recorded: intensity of pain at arrival, after 30, 60 and 90 min and at discharge from the PACU; total consumption of oxycodone/fentanyl; nausea; vomiting; sedation and pressure tolerance thresholds. Results: The median intra‐ and post‐operative consumption of oxycodone was 15 mg (range: 10–40 mg) and the consumption of fentanyl was 200 μg (range: 100–500 μg). The intensity of abdominal pain was significantly lower in the oxycodone group at arrival ( P <0.05), after 30, 60 and 90 min, and at discharge from the PACU ( P <0.01). There was a strong tendency towards more side effects with oxycodone. Conclusions: Oxycodone provided better analgesia but also more side effects, suggesting that the doses used in the present study may not be equipotent.