title: Prolonged-release oxycodone/naloxone in postoperative pain management: from a randomized clinical trial to usual clinical practice.
abstract: OBJECTIVE
  These studies evaluated the feasibility of using oral prolonged-release oxycodone/naloxone (OXN PR) for the management of acute postoperative pain.
  
  
  METHODS
  Three studies were undertaken: (i) the analgesic efficacy of OXN PR was compared with prolonged-release oxycodone (OXY  PR) in patients with knee arthroplasty in an immediate postoperative period (IPOP) study; (ii) OXN PR treatment was compared with other opioids during rehabilitation after knee arthroplasty in a noninterventional study (NIS); and (iii) surgical patients on other opioids were switched to OXN  PR postoperatively during a quality improvement programme (QIP).
  
  
  RESULTS
  In the IPOP study, the pain intensity at rest score decreased by a similar amount in the OXN PR and OXY PR groups, indicating similar analgesic efficacies. In the NIS, patient assessments indicated enhanced efficacy  and tolerability for OXN PR compared with other opioids. The QIP indicated significant improvements in bowel function and less difficulty passing urine at the end of OXN PR treatment compared with baseline. No safety concerns were raised.
  
  
  CONCLUSIONS
  The analgesic efficacies of OXN PR and  OXY PR were similar in postoperative pain settings. OXN PR reduced the degree of restriction in relation to patients carrying out physiotherapy compared with other opioids, and improved bowel and bladder function.
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: K
authors.initials: K
authors.lastname: Kuusniemi
authors.forename: J
authors.initials: J
authors.lastname: Zöllner
authors.forename: S
authors.initials: S
authors.lastname: Sjövall
authors.forename: J
authors.initials: J
authors.lastname: Huhtala
authors.forename: P
authors.initials: P
authors.lastname: Karjalainen
authors.forename: M
authors.initials: M
authors.lastname: Kokki
authors.forename: J
authors.initials: J
authors.lastname: Lemken
authors.forename: J
authors.initials: J
authors.lastname: Oppermann
authors.forename: H
authors.initials: H
authors.lastname: Kokki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D019645:Arthroplasty, Replacement, Knee; D003248:Constipation / Q000139:chemically induced; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000009:adverse effects; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000008:administration & dosage* / Q000009:adverse effects; D010098:Oxycodone / Q000008:administration & dosage* / Q000009:adverse effects; D059408:Pain Management; D010149:Postoperative Pain / Q000188:drug therapy*; D013131:Spine / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations; D004338:Drug Combinations; D009270:Naloxone; D010098:Oxycodone