Oxycodone Versus Morphine for Analgesia After Laparoscopic Endometriosis Resection

Lijun Niu; Lihong Chen; Yanhua Luo; Wenkao Huang; Yunsheng Li

Disclosures

BMC Anesthesiol. 2021;21(194) 

In This Article

Background

Deep infiltrating endometriosis (DIE) is a specific form of endometriosis characterized by endometriosis implants that penetrate for more than 5 mm in the affected tissue, which includs bladder, ureter, vagina, rectum, uterosacral ligaments, etc. Medical treatment for DIE is usually limited, complete excision of the lesions under the laparoscopy is the preferred method.[1] Pain is the most prominent symptom of DIE, and there are some studies about long-term pain control after DIE excision,[2,3] but there is no research on analgesia after laparoscopic DIE resection.

Incisional pain, shoulder pain, and visceral pain are three main types of pain after laparoscopic surgery.[4] The prominent type of pain in the first 24 h after surgery varies from surgery to surgery, and there are no studies on the pain characteristics within 24 h after laparoscopic DIE resection.

Oxycodone, which is a semisynthetic μ- and κ-opioid receptor agonist, can provide better analgesia than pure μ-opioid receptor agonists after some surgeries due to the critical role of κ-opioid receptors in the reduction of visceral pain.[5–8] However, its analgesic effect after laparoscopic DIE resection is unknown.

Since DIE resection involved one or more abdominal internal organs, we speculated that visceral pain was an important component of the pain after laparoscopic DIE resection. Given that oxycodone had both μ-and κ-opioid receptor agonist, we hypothesized that oxycodone was more potent than morphine for analgesia after laparoscopic DIE resection. This present study aimed to confirm visceral pain was an important component of the pain after laparoscopic DIE resection and compare the analgesic potency and side effects of oxycodone versus morphine, in order to provide a better choice for good analgesia after laparoscopic DIE resection.

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