title: A randomized, double-blind, placebo-controlled study of preemptive oral oxycodone with morphine patient-controlled anesthesia for postoperative pain management in patients undergoing uterine artery embolization for symptomatic uterine fibroids.
abstract: OBJECTIVE
  To evaluate the analgesic efficacy of oral premedication of oxycodone in a group of patients undergoing elective uterine artery embolization under sedation for fibroid disease.
  
  
  METHODS
  Thirty-nine patients (mean age 42.3 years) were prospectively randomized 1:1 to receive 20 mg oxycodone or placebo orally immediately before their procedure. At the commencement of the procedure, patients were provided with a patient-controlled analgesia device for 24 h, programmed to deliver 1 mg boluses of intravenous morphine with a 5 min lockout. Mean visual analog scale pain intensity ratings (0-100 mm) were measured from both groups and evaluated over 0 to 6 h as the primary end point. Other measured parameters included opioid-related side effects and eligibility for discharge (NCT00163930; September 12, 2005).
  
  
  RESULTS
  Early pain intensity did not vary significantly between the active and placebo groups [mean (standard deviation): 3.2 (2.5) vs. 3.1 (2.2), p = 0.89]. The oxycodone group, however, experienced significantly more nausea (p = 0.035) and a greater incidence of vomiting (p = 0.044). Overall opioid requirement over 24 h, measured as oral morphine equivalent, was greater in the oxycodone group (median [interquartile range]: 64.5 [45-90] mg vs. 22.5 [15-46.5] mg, p < 0.0001). The number of patients first eligible for discharge at 24 h in the oxycodone group was decreased but not significantly (p = 0.07).
  
  
  CONCLUSIONS
  The addition of preprocedural oral oxycodone to morphine patient-controlled analgesia does not offer any analgesic advantage to patients having uterine artery embolization and may cause a greater incidence of nausea and vomiting.
authors: Department of Anaesthesia, The Alfred Hospital, Melbourne, VIC, 3004, Australia, a.konstantatos@alfred.org.au.
authors: Alex H
authors: AH
authors: Konstantatos
authors: Helen
authors: H
authors: Kavnoudias
authors: James R
authors: JR
authors: Stegeman
authors: Dana
authors: D
authors: Boyd
authors: Maryann
authors: M
authors: Street
authors: Michael
authors: M
authors: Bailey
authors: Stuart M
authors: SM
authors: Lyon
authors: Kenneth R
authors: KR
authors: Thomson
mesh_terms: D000284:Administration, Oral; D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000628:therapy*; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use*; D010098:Oxycodone / Q000008:administration & dosage / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000009:adverse effects* / Q000379:methods
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine; D010098:Oxycodone