Clinical trials related to the use of oral
oxycodone for
acute postoperative pain management were searched via PubMed and Medline from 2003 to 2015. The search terms used were "oral strong
opioids," "postsurgical," "postoperative," "post-surgical," and "post-operative." Treatment interventions were compared for
analgesic efficacy, rescue medication use, side effects, recovery, length of
hospital stay, and patient satisfaction.
RESULTS: There were 26 clinical trials included in the review. Oral
oxycodone showed superior postoperative
analgesic efficacy compared with placebo in patients undergoing
laparoscopic cholecystectomy, abdominal or pelvic surgery, bunionectomy, breast surgery, and spine surgery. When compared with intravenous
opioids, oral
oxycodone provided better or comparable
pain relief following
knee arthroplasty, spine surgery,
caesarean section, laparoscopic colorectal surgery, and cardiac surgery. One study of dental postsurgery
pain reported inferior
pain control with oral
oxycodone versus
rofecoxib. (withdrawn from the US market due to cardiac safety concerns). In many studies, the demand for rescue
analgesia and total
opioid consumption were reduced in the
oxycodone treatment arm. Patients receiving oral
oxycodone experienced fewer
opioid-related side effects than those on other
opioids, and had a similar occurrence of
postoperative nausea and vomiting as patients on placebo. Furthermore, oral
oxycodone did not prolong
hospital stay and was associated with lower drug costs compared with epidural and intravenous
analgesics.
Oxycodone administered as part of a multimodal
analgesic regimen produced superior
pain relief with fewer side effects and a reduced
hospital stay.
LIMITATIONS: There is a limited number of randomized double blinded studies in individual surgical operations, thus making it more difficult to come up with definitive conclusions.
CONCLUSION: