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

Results

Out of 50 patients assessed for eligibility, 48 were enrolled and randomly assigned to each of the two groups, and 45 (90%) completed the study (Figure 1, CONSORT flow diagram). The demographic variables and operative characteristics, including age, BMI, ASA class, surgical duration, time of carbon dioxide pneumoperitoneum, length of stay in the PACU, and excision site were statistically insignificant between the groups (Table 1).

Figure 1.

Consolidated Standards of Reporting Trials (CONSORT) flow diagram. IV-PCA, intravenous patient-controlled analgesia; ICU, intensive care unit. Group O, oxycodone IV-PCA (oxycodone 1 mg/mL; no background infusion; bolus 2 mg; lock-out time of 8 min). Group M, morphine IV-PCA (morphine 1 mg/mL; no background infusion; bolus 2 mg; lock-out time of 8 min)

Total opioid consumption was higher in group M (mean ± SD, 20.14 ± 3.83) than in group O (mean ± SD,14.42 ± 2.83). More specifically, morphine consumption was higher than oxycodone consumption at all postoperative time intervals except at 8–12 h (Figure 2A). Meanwhile, the total number of IV-PCA bolus in the first 24 h after surgery was less in the group O (n, 78) than that in the group M (n, 123). In detail, the number of IV-PCA bolus was less in the group O than in the group M at 0–2 h and 4–8 h (p < 0.05, Figure 2B). The VAS score in group O [interquartile range (IQR), 3(2–3)] was the lower at the 4th hour compared with group M [interquartile range (IQR), 3(2.75–4)] (p < 0.01, Table 2), but there were no significant differences at the other time points (Table 2). The average time to first request for analgesia was significantly shorter in group M (mean ± SD, 97.27 ± 59.79) than in group O (mean ± SD, 142.17 ± 51) (p < 0.01, Figure 3).

Figure 2.

Oxycodone and morphine consumption, and the number of IV-PCA bolus during the 24-h postoperative period. Data are displayed as mean ± SD or n. *compared with group O, p < 0.05; #compared with group O, p < 0.01

Figure 3.

The time to first request for morphine between oxycodone and morphine group during the 24-h postoperative period. Data are mean ± SD. *compared with group O, p < 0.01;

There was no difference in Ramsay scores between groups at any time points (Table 2). The overall incidence of nausea was higher in group M (%, 39.17) than in group O (%, 19.13). More specifically, the incidence of nausea was higher in group M than in group O at 0–2 h, 2–4 h, and 12–24 h. The overall incidence of vomiting was higher in group M (%, 27.27) than it was in group O (%, 13.92), despite no difference was observed between groups at different observation intervals. There was no difference in the incidence of respiratory depression and bradycardia between groups (Table 2).

Of the three types of pain that prompted patients to request analgesia, the incidence of visceral pain was highest, either at different observation intervals or in different groups or all patients, except at 0–2 h in group O. The incidence of shoulder pain was higher than that of incision pain at 0–24 h in all groups (Table 3).

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