Oxycodone vs. fentanyl in the treatment of early post-operative pain after laparoscopic cholecystectomy: a randomised double-blind study.
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 microg fentanyl at the end of anaesthesia. In the post-anaesthetic care unit (PACU), 5 mg oxycodone/50 microg fentanyl was administered to patients with moderate pain [3-5 on a numeric rating scale (NRS)], and 10 mg oxycodone/100 microg 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 microg (range: 100-500 microg). 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.
Koch
S
S
Department of Anaesthesiology, Aarhus University Hospital, Aarhus, Denmark.
Ahlburg
P
P
Spangsberg
N
N
Brock
B
B
Tønnesen
E
E
Nikolajsen
L
L
D015746:Abdominal Pain / Q000188:drug therapy*; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D002985:Clinical Protocols; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010098:Oxycodone / Q000627:therapeutic use*; D010147:Pain Measurement / Q000379:methods / Q000706:statistics & numerical data; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D010098:Oxycodone; D005283:Fentanyl