Comparison of the analgesic efficacy of oxycodone and fentanyl after dental surgery

ABSTRACT

BACKGROUND: Oxycodone is a strong m-opioid receptor agonist and has a longer duration of analgesic effect than fentanyl. We compared the use of an intravenous (IV) bolus of oxycodone and fentanyl for postoperative analgesic efficacy after dental surgery. METHODS: Patients underwent surgical extraction under general anesthesia. We prospectively enrolled patients who had received IV oxycodone (n = 36, 0.05 mg/kg) and fentanyl (n = 36, 1 mg/kg) 10 minutes before the end of surgery. The recovery profiles (hemodynamic variables, pain score, postoperative nausea and vomiting, sedation scale, and adverse events) were recorded for 1 hour in the post-anesthetic care unit (PACU) and at 6 hours after surgery. RESULTS: Under a potency ratio of 501 (oxycodonefentanyl), time to spontaneous ventilation was significantly longer in the oxycodone group (8.1 ± 2.8 min vs. 6.9 ± 1.8 min, P = 0.021). The overall pain scores were significantly lower in the oxycodone than in the fentanyl group (P < 0.001), and the oxycodone group had significantly fewer additional analgesic requirements in the PACU than the fentanyl group (8.3% vs. 27.8%, P = 0.032). The incidence of postoperative nausea and sedation were comparable in both groups. No opioid-related adverse event was identified. CONCLUSIONS: In dental surgery, 0.05 mg/kg IV oxycodone had a longer-lasting analgesic effect than that of 1 µg/kg IV fentanyl, and could reduce total opioid consumption without increasing side effects. Patients experienced satisfactory analgesia postoperatively; thus, oxycodone is an effective opioid analgesic for acute postoperative pain relief.