Open AccessGastrointestinal Adverse Events in Hospitalized Patients Following Orthopedic Surgery: Tapentadol Immediate Release Versus Oxycodone Immediate Release
Author(s) -
Xinyi Wang,
Sujita W. Narayan,
Jonathan Penm,
Charlotte Johnstone,
Asad E. Patanwala
Publication year - 2021
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2021/24/e309
Subject(s) - medicine , tapentadol , oxycodone , retrospective cohort study , anesthesia , orthopedic surgery , medical record , adverse effect , opioid , surgery , receptor
Background: Tapentadol has relatively less effect on μ-opioid receptors compared with otheropioids. This has the potential to reduce the occurrence of gastrointestinal (GI) adverse drug events(ADEs).Objectives: To compare the GI ADEs during hospitalization between tapentadol immediaterelease (IR) and oxycodone IR following orthopedic surgeries.Study Design: Retrospective cohort study.Setting: A major metropolitan tertiary referral hospital in Australia.Methods: Data for adult orthopedic surgery patients receiving postoperative tapentadol IR oroxycodone IR during hospitalization between January 1, 2018 and June 30, 2019, were collectedfrom electronic medical records. The primary outcome was the occurrence of postoperative GIADEs occurring during hospitalization. This was defined as a composite of nausea, vomiting, orconstipation.Results: The study cohort included 199 patients. Of these, 99 patients received tapentadol IRand 100 patients received oxycodone IR for postoperative pain during hospitalization. The meanage was 66 ± 12 years, and 111 patients (56%) were women. There was no significant differencebetween groups on the occurrence of GI ADEs (53% in oxycodone group and 51% in tapentadolgroup, difference 2%, 95% confidence interval [CI], –11% to 16%; P = 0.777). After adjusting forpotential confounders, the use of tapentadol IR was not associated with a significant reduction ofGI ADEs (odds ratio, 0.62; 95% CI, 0.32–1.20; P = 0.154).Limitations: This was a single-center study and should be extrapolated with caution. As this wasa retrospective study, the accuracy and availability of data were dependent on documentation inelectronic medical records.Conclusions: Tapentadol IR is associated with similar GI ADE occurrence compared withoxycodone IR in patients with orthopedic postoperative pain during hospitalization.Key words: Opioid analgesics, tapentadol, oxycodone, orthopedic procedures, postoperativepain, acute pain, gastrointestinal adverse drug events, opioid-induced adverse drug events