title: Oxycodone versus fentanyl for intravenous patient-controlled analgesia after laparoscopic supracervical hysterectomy: A prospective, randomized, double-blind study.
abstract: BACKGROUND
  Oxycodone, a semisynthetic thebaine derivative opioid, is widely used for the relief of moderate to severe pain. The aim of this study was to compare the efficacy and side effects of oxycodone and fentanyl in the management of postoperative pain by intravenous patient-controlled analgesia (IV-PCA) in patients who underwent laparoscopic supracervical hysterectomy (LSH).
  
  
  METHODS
  The 127 patients were randomized to postoperative pain treatment with either oxycodone (n = 64, group O) or fentanyl group (n = 63, group F). Patients received 7.5 mg oxycodone or 100 μg fentanyl with 30-mg ketorolac at the end of anesthesia followed by IV-PCA (potency ratio 75:1) for 48 hours postoperatively. A blinded observer assessed postoperative pain based on the numerical rating scale (NRS), infused PCA dose, patient satisfaction, sedation level, and side effects.
  
  
  RESULTS
  Accumulated IV-PCA consumption in group O was less (63.5 ± 23.9 mL) than in group F (85.3 ± 2.41 mL) during the first 48 hours postoperatively (P = 0.012). The NRS score of group O was significantly lower than that of group F at 4 and 8 hours postoperatively (P < .001); however, the incidence of postoperative nausea and vomiting (PONV), dizziness, and drowsiness was significantly higher in group O than in group F. Patient satisfaction was lower in group O than in group F during the 48 hours after surgery (P < 0.001).
  
  
  CONCLUSIONS
  Oxycodone IV-PCA (potency ratio 1:75) provided superior analgesia to fentanyl IV-PCA after LSH; however, the higher incidence of side effects, including PONV, dizziness, and drowsiness, suggests that the doses used in this study were not equipotent.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Cheonan, 23-20, Byeongmyeong-dong, Dongnam-gu, Cheonan, Chungcheongnam-do Department of anesthesiology and pain medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon-si, Gyeonggi-do Department of Biostatistics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul Department of obstetrics and gynecology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan-si, Chungcheongnam-do, Republic of Korea.
authors.forename: Nan Seol
authors.initials: NS
authors.lastname: Kim
authors.forename: Jeong Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Su Yeon
authors.initials: SY
authors.lastname: Park
authors.forename: Aeli
authors.initials: A
authors.lastname: Ryu
authors.forename: Hea Rim
authors.initials: HR
authors.lastname: Chun
authors.forename: Ho Soon
authors.initials: HS
authors.lastname: Chung
authors.forename: Kyou Sik
authors.initials: KS
authors.lastname: Kang
authors.forename: Jin Hun
authors.initials: JH
authors.lastname: Chung
authors.forename: Kyung Taek
authors.initials: KT
authors.lastname: Jung
authors.forename: Seong Taek
authors.initials: ST
authors.lastname: Mun
mesh_terms: D000328:Adult; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007044:Hysterectomy; D007262:Infusions, Intravenous; D010535:Laparoscopy; D008875:Middle Aged; D010098:Oxycodone / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies
chemical_list: D000701:Analgesics, Opioid; D010098:Oxycodone; D005283:Fentanyl