Comparison of oxycodone and fentanyl for postoperative patient-controlled analgesia after orthopedic surgery

ABSTRACT

BACKGROUND: Oxycodone is widely used as bolus or patient-controlled analgesia (PCA) for control of postoperative pain. The aim of this study was to assess the efficacy and side effects of oxycodone for somatic pain by comparing oxycodone and fentanyl intravenous PCA after orthopedic surgery. METHODS: Seventy-three patients undergoing orthopedic surgery were randomly assigned to receive fentanyl or oxycodone using intravenous PCA (potency ratio 160). Pain severity at rest and with movement and adverse effects were assessed at 1, 6, 24, and 48 hours after surgery. The PCA dose and patient satisfaction scores were measured at 48 hours after surgery. RESULTS: The resting visual analogue scale (VAS) and moving VAS scores of the oxycodone group were significantly higher than those of the fentanyl group at 6 hours (P = 0.001, P = 0.021), but at 48 hours, the resting and moving VAS of the oxycodone group were significantly lower than those of the fentanyl group (P = 0.014, P = 0.037). There were no significant differences in adverse effects, satisfaction scores, dose of patient-controlled mode, or total cumulative PCA dose. CONCLUSIONS: With a 160 ratio of oxycodone to fentanyl when using PCA for pain control after orthopedic surgery, the use of larger doses of oxycodone for 6 hours is effective in controlling early postoperative pain.