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  • Kim 2015, Oxycodone Vs Fentanyl

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    Kim 2015, Oxycodone Vs Fentanyl

    Enviado por

    Aida Tantri
    oxycodone

    Direitos autorais:

    © All Rights Reserved
    Baixe no formato PDF ou leia online no Scribd
    Sinalizar o conteúdo como inadequado
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    Clinical Research Article ASN 2005 419 SH 2005 7588 A comparison of oxycodone and fentanyl in intravenous patient-controlled analgesia after laparoscopic hysterectomy Korean Journal of Anesthesiology Nan-Seol Kim’, Kyu Sik Kang’, Sie Hyeon Yoo', Jin Hun Chung’, Ji-Won Chung’, Yonghan Seo’, Ho-Soon Chung’, Hye-Rim Jeon', Hyung Youn Gong’, Hyun-Young Lee', and Seong-Taek Mun® Departmens of Aethsology end Pa Medicine, “Obterics and Gynecology, Soonlunyang University Chonan Hospital, Soondwayung Univers Clee of Medicine, Conan, Korea Background: We planned to compare the effet of intravenous oxycodone and fentanyl on post-operative pain after lapa- roscopic hysterectomy. Methods: We examined 60 patients were randomized to postoperative pain treatment with either oxycodone (n = 30, Group 0) or fentanyl (n= 30, Group F). The patients received 10 mg oxycodone!100 yi fentanyl with ketorolac 30 mg before the end of anesthesia and then continued with patient-conttlled analgesia for 48h postoperatively Results: The accumulated oxycodone consumption was ess than fentanyl during 8 24 and 48 h postoperatively, Numeric rating score of Group © showed signficamly lower than that of Group F during 30 min, 2, 4, 8 and 24h postoperatively The incidences of adverse reactions wete similar in the two groups, though the incidence of nausea was higher in the Group O during the 24 and 48h postoperative period. Conclusions: Oxycodone 1V-PCA was more advantageous than fentanyl TV-PCA for laparoscopic hysterectomy in view of accumulated oxycodone consumption, pain contol and cost beneficial effect. However, patient satisfaction was not {00d inthe group O compared to group F Key Words: Fentanyl, Oxycodone, Postoperative ps CConespending author: Kyu Sk Kang, 34D, PhD. Department of Anesthesiology and Pain Medicine, Soonchunhyang, University Cheonan Hospital, Soonchunbyang Universy Cllege of Medicine, 3, Sancheoniyang 6 i, Dongnam- gu, Cheonan 330-721, Korea “Th 42-41-870.2722, Pa #241 973-3889 Ema bjketechea eke Received November 26,2014, Rewsed: December 24, 2014 Accepted: December 31,2014 Korean | Anesthesiol 2018 June 68(3} 261-256 tp dl ory/10.4097jae 2015683261, Introduction ‘While several methods can be used for postoperative pain ‘management, intravenous patent-controlled analgesia (IV-PCA) is the most common, a it provides efficacious postoperative an ‘algesa and high patient satisfaction with minimal sedation and complication [1]. ‘The most commonly-used drugs for IV-PCA ate opioids, Including morphine. Morphine has been the single most studied ‘and used drug for IV-PCA and is therefore considered the gold standard analgesic for IV-PCA, However, due to its hydrophilic © Tob san operscces ance dseuted unde the ems of he Creative Commrans Atbuton Non-Commercial License (hipilretvecommont org ‘eease/y ac), which perals used no commercl se, dsrbton, and epradetion any medi, pede he xgtl work pepe ced Copyright the Korean Society of Anestesiologs,2015, Ontine access hip/eljaorg ‘Oxycodone vs. fntanylin WPCA property; morphine cannot cross the blood-brain barrier e8s- yy delaying the onset of effects. Moreover its active metabolite, morphine-6-glucurenide, lowers the metabolism of patients ‘with impaired renal functions, which may reslt in unexpected complications such a respiratory depression [1,2]. ‘Our hospital uses fentanyl, which fs 80100 times more po- teat than morphine. In addition, is high lipid solubility educes| ‘the onsot ime, making it suitable for IV-PCA (1,2) Dihydrohydroxycodeinone (oxycodone) isa thebaine de- rlvative and is structurally similar to morphine. I is @ potent agonist, with a potency comparable to that of morphine [3]. In Finland, parenteral oxycodane has been used in acute pain control since the 1940s [4]: nevertheless, there have been few studies on the analgesic efficacy of fentanyl and exyeodone for IV-PCA in postoperative pain management (5) ‘This study therefore set out to compare the analgesic efficacy ‘Side effects, and patient satisfaction ratings of fentanyl and oxy- ccodone, two common analgesics used in our hospital for 1V- PCA following laparoscopic hysterecamny Materials and Methods “This study was conducted ater receiving approval from our hospitals Institutional Review Board. I involved 60 adult patients ‘between the ages of 18-70 who had been classified as American Society of Anesthesilogists (ASA) physical status 1 and 2, were scheduled for laparoscopic hysterectomy at our hospitel, and had requested IV-PCA afer the operation. Patients with a history of bleeding tendencies, hepatitis and renal failure, those with habitual sedative or other drug use, ‘those with mental diseases, and those not suitable for IV-PCA, were excluded from the study. ‘The purpose ofthe study, PCA instructions, numeri rating scale (NRS) calculation method, and side eects were explained Table 1. Demographic Deta and Anesthesa Characteristics ‘GrospP Group G3) 30) aeeon) 1253 6=86 ASA physlet statue vl Bi 24s Smoker/nonsmoker 426 416 History of motion sickessor PONY 12(4088) 133%) Heght (on) wsaoz44 1866247 Weight (i) saae9s Duration of surgery (iin) n3230 Toul propofel consumption (mg) 76092 2223 697.0 1574 ‘otal vemifentni consumption (yg) 679.22 191.0 60562089 ‘Ylues re expeted ae mean © SD or numberof patents (), Nosign- fan difrences been the props. Group Ffeany! group, Group O. ‘oxycodone group, PONV: postoperative nausea and vomiting 262 VOL. 68, NO. 3, JUNE 2015 to the patients one day before the surgery and written consent forms were collected. The patients were randemly divided into ‘wo groups a grup ssngfertany forthe TV-PCA (Group Fn = 30) and a group using oxycodone for the IV-PCA (Group O,n = 3). There was no statistically significant diference between the two groups in terms of patients’ age, height, weight, duration of operation, ASA physical status, smoking habits and intensity of motion scknes (Table. “The patients were not given sny preanesthetie medication, and venous access was achieved with an 18G nel before they were moved to the operating room. Upon arrival inthe opeat~ ing room, te patients were connected to an electrocardiogram ‘monitor, onirwasive blood pressure monitoring device, and pulse oximeter. After connecting the monitoring devices, .2 sg of glycopyrrolate (Mobinal”™, Myangmoon, Seoul, Keres) was administered intravenously and preoaygenation was per~ formed with 100% oxygen at § L/min. Then, an Orchestra” Base Primea (Fresenius Vial, Brezins, France) pump was used to initiate the administration of remifentanil (Uva, Glaxo- SmithKline, Verona, aly) with an effect-site concentration of 440 ng/ml After the targeted concentration of remifentanil was achieved, propofol (Presofol MCT 2%™, Fresenius Kab, Graz, Austria) was administered with an effect-site concentration of ‘ulmi. Upon confirming the loss of response to verbal orders (08 mgikg of rocuronium bromide (Esmeron™. Organon, The "Netherlands was intravenously administered, and endotracheal {intubation was performed 90 seconds later. Mechanical venti tion was then initiated to oxygenate the patient with FIO, of (04 and maintain an end-tidal carbon dioxide of 30-40 mmlig. ‘The effect-site concentrations of propofol and remifentanil were

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