We compared the analgesic profile between patient-controlled analgesia (PCA) using oxycodone and morphine in post total abdominal hysterectomy patients. Eighty-four ASA I or II patients, aged 18 to 65 years who underwent total abdominal hysterectomy were recruited into this prospective, double blind, randomised controlled study. They were randomised to receive either PCA oxycodone 0.7 mg per bolus or PCA morphine 1 mg per bolus for postoperative pain relief. At the end of surgery, all patients received IV morphine 0.1 mg/kg and skin incision was infiltrated with 20 mls of bupivacaine 0.25%. Post-operative pain scores, opioids consumptions, sedation scores and side effects were assessed upon arrival and at 30 minutes after arrival to recovery area, as well as at 6 hours and 24 hours after the operation in the ward. Patients’ overall satisfaction was also assessed 24 hours postoperatively.No significant differences were observed in terms of postoperative pain scores, opioids consumption, sedation scores, side effects as well as patient’s overall satisfaction between the PCA oxycodone and PCA morphine group. Oxycodone was comparable to morphine as PCA in terms of total opioid consumption, pain scores and satisfaction level for patients undergoing total abdominal hysterectomy and therefore may be an alternative to morphine in postoperative pain management as PCA
morphine ; oxycodone ; pain scores ; patient controlled analgesia ; total abdominal hysterectomy

BACKGROUND: Total knee replacement is often accompanied by severe post-operative pain. Oxycodone has sufficient analgesic effects and somewhat greater, but tolerable side effects compared to fentanyl. However, most studies on the topic evaluate visceral pain relief. In this study, we determine the effectiveness of oxycodone for somatic pain and evaluate the incidence of side effects. METHODS: Sixty-nine patients were involved in a randomized control trial. Analgesic agents were administered to two experimental groups at a post anesthetic care unit (PACU) 15 min after PACU admission: a 50 µg fentanyl group (n = 40) and a 4 mg oxycodone group (n = 29), both with severe pain (numeric rating scale, NRS > 5). Changes in NRS at the PACU were measured. Additional analgesic agents were administered at 0–6, 6–12, 12–24, and 24–48 h after surgery. RESULTS: Total fentanyl consumption and the number of patients who required additional opioids were significantly lower in the oxycodone group than in the fentanyl group. Incidence of side effects was not significantly different between the two groups. CONCLUSIONS: Oxycodone shows a better analgesic effect than fentanyl in somatic pain in the acute phase of post-operative pain. The side effects of oxycodone are not significantly different from those of fentanyl.
Analgesics ; Analgesics, Opioid ; Arthroplasty, Replacement, Knee* ; Fentanyl* ; Humans ; Incidence ; Nociceptive Pain ; Oxycodone* ; Visceral Pain

PURPOSE: Adequate control of breakthrough pain is essential for patients with cancer. Managing breakthrough pain mainly depends on understanding the concept of breakthrough pain and the proper usage of rescue medication by physicians. This study aims to assess the attitudes and practice patterns of palliative physicians in managing breakthrough pain for patients in Korea. METHODS: This study was based on data from the 2014 breakthrough cancer pain survey conducted by the Korean Society for Hospice and Palliative Care. One hundred physicians participated in the online survey. Among total 33 self-reported questionnaires, twelve items were selected in this analysis. RESULTS: Rapid onset of action is the main influencing factor in selecting rescue opioids. Oral oxycodone (65%) and parenteral morphine (27%) are commonly used. A few physicians (3%) prefer to use transmucosal fentanyl. The percentage of physicians prescribing oral oxycodone due to its rapid onset of action is just 21.5%, whereas the percentage of physicians using parenteral morphine is 81.5%. Two thirds of respondents (66%) answered that breakthrough pain is not well controlled with rescue medications. CONCLUSION: There is a gap between the needs of physicians in terms of the perceived difficulties of managing breakthrough cancer pain and their practice patterns selecting rescue medications.
Analgesics, Opioid ; Breakthrough Pain ; Fentanyl ; Hospices ; Humans ; Korea* ; Morphine ; Oxycodone ; Palliative Care ; Surveys and Questionnaires

Fentanyl is the most commonly used opioid analgesic in intravenous patient-controlled analgesia (IV PCA) in Korea. IV oxycodone was approved for postoperative IV PCA by the Ministry of Food and Drug Safety of Korea in 2013. The approved dosage regimen for postoperative pain relief with IV oxycodone is IV bolus loading of 2 mg followed by PCA composed of demand boluses of 1 mg and no background infusion with an oxycodone concentration of 1 mg/ml. However, a simulation study indicated that the minimum effective analgesic concentration (MEAC, as indicated by relief of pain by administering rescue analgesics) of oxycodone was reached most quickly with a higher loading dose of 0.1 mg/kg and IV PCA with background infusion. Oxycodone is a therapeutic option as an analgesic for postoperative pain management. It is necessary to reduce the analgesic dose of oxycodone in elderly patients because metabolic clearance decreases with age.
Aged ; Analgesia, Patient-Controlled ; Fentanyl ; Humans ; Korea ; Oxycodone* ; Pain, Postoperative* ; Passive Cutaneous Anaphylaxis

PURPOSE: The purpose of this study was to assess the factors influencing the rescue medication decisions for breakthrough cancer patients and evaluate treatments using the factors. METHODS: Based on the results of an online survey conducted by the Korean Society of Hospice and Palliative Care from September 2014 through December 2014, we assessed the level of agreement on nine factors influencing rescue medication preference. The same factors were used to evaluate oral transmucosal fentanyl lozenge, oral oxycodone and intravenous morphine. RESULTS: Agreed by 77 physicians, a rapid onset of action was the most important factor for their decision of rescue medication. Other important factors were easy administration, strong efficacy, predictable efficacy and less adverse effects. Participants agreed that intravenous morphine produced a rapid onset of action and strong and predictable efficacy and cited difficulty of administration and adverse effects as negative factors. Oral oxycodone was desirable in terms of easy administration and less adverse effects. However, its onset of action was slower than intravenous morphine. While many agreed to easy administration of oral transmucosal fentanyl lozenge, the level of agreement was low for strength and predictability of its efficacy, long-term durability and sleep improvement. CONCLUSION: Rapid onset of action is one of the important factors that influence physicians' selection of rescue medication. Physicians' assessment of rescue medication differed by medication.
Analgesics, Opioid ; Breakthrough Pain ; Fentanyl ; Hospices ; Humans ; Morphine ; Oxycodone ; Palliative Care

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 1:60). 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 1:60 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.
Analgesia, Patient-Controlled* ; Fentanyl* ; Humans ; Nociceptive Pain ; Orthopedics* ; Oxycodone* ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction

OBJECTIVE: To observe the effectiveness and safety of electrothermal acupuncture therapy for patients of moderate to severe cancer pain with METHODS: A total of 60 patients of moderate to severe cancer pain with RESULTS: The variation of NRS scores in the observation group were larger than the control group 3, 5 days into treatment ( CONCLUSION On the basis of the conventional western medication for analgesia, electrothermal acupuncture could relieve pain, reduce the dose of opioid painkillers and improve the quality of life in patients of moderate to severe cancer pain with
Acupuncture Points ; Acupuncture Therapy ; Cancer Pain/therapy* ; Humans ; Neoplasms/therapy* ; Oxycodone ; Quality of Life ; Treatment Outcome

OBJECTIVE: To observe the clinical efficacy of Miao medicinal crossbow acupuncture therapy as adjuvant treatment for lung cancer pain based on oxycodone hydrochloride extended-release tablet. METHODS: A total of 60 patients with lung cancer pain were randomized into an observation group (30 cases, 1 case dropped off) and a control group (30 cases). In the control group, oxycodone hydrochloride extended-release tablet was given orally, 10 mg a time, once every 12 hours. On the basis of the treatment in the control group, Miao medicinal crossbow acupuncture therapy was applied once every other day in the observation group. The treatment of 14 days was required in the two groups. Before and after treatment, the numerical rating scale (NRS) score, number of break-out pain and Karnofsky performance status (KPS) score were observed in the two groups. The equivalent oxycodone consumption and rate of adverse reactions were recorded, the analgesic effect was evaluated in the two groups. RESULTS: Compared before treatment, the NRS scores and number of break-out pain were decreased while the KPS scores were increased after treatment in the two groups (P<0.01). After treatment, the NRS score and number of break-out pain in the observation group were lower than the control group (P<0.01), the KPS score in the observation group was higher than the control group (P<0.05). The equivalent oxycodone consumption of whole course and the rate of adverse reactions i.e. constipation, drowsiness, nausea and vomiting in the observation group were lower than the control group (P<0.05). The analgesic effect rate was 93.1% (27/29) in the observation group, which was superior to 63.3% (19/30) in the control group (P<0.05). CONCLUSION On the basis of oxycodone hydrochloride extended-release tablet, Miao medicinal crossbow acupuncture therapy as adjuvant treatment can effectively relieve the pain degree, reduce the number of break-out pain and improve the health status and quality of life in patients with lung cancer pain, enhance the efficacy of medication and reduce its adverse reactions.
Humans ; Cancer Pain ; Oxycodone ; Quality of Life ; Lung Neoplasms ; Pain ; Acupuncture Therapy ; Adjuvants, Immunologic ; Lung ; Analgesics

BACKGROUND: Although oxycodone has been known to be superior to other opioids in postoperative care, few studies have compared its analgesic potency with that of fentanyl. We therefore examined these two drugs in terms of their dose requirements, effects on pain intensity, time needed for relief of pain, and side effects after surgery. METHODS: We enrolled 56 healthy women scheduled for total abdominal hysterectomy and randomly allocated them to either oxycodone or fentanyl. The opioids were administered to the two groups 10 minutes before the end of the operation. In the post-anesthesia care unit (PACU) after surgery, a visual analog scale (VAS) was used to assess the patients' pain every 10 minutes Whenever pain control was required, a bolus of the same dose of the respective drugs was repeated at 10-minute intervals. Patient-controlled analgesia (PCA) was used to manage postoperative pain. After the patient arrived on the ward, pain scores were recorded at once and then 1, 2, 3, and 24 hours thereafter. RESULTS: During the hour spent in the PACU, fewer patients in the oxycodone group required the opioid, and the time needed to achieve pain relief was shorter with oxycodone than with fentanyl. Moreover, postoperative VAS levels were significantly lower in the oxycodone group both in the PACU and on the ward (over a 24-hours period). There were no significant differences in side effects between the patients given oxycodone and those given fentanyl. CONCLUSIONS: Oxycodone was more effective than fentanyl when administered on the basis of the recommended dose ratio (1 : 100). Although further evaluation is needed to investigate the optimal dose ratio, we would recommend a higher conversion factor (1 : 62).
Analgesia ; Analgesia, Patient-Controlled* ; Analgesics, Opioid ; Female ; Fentanyl* ; Humans ; Hysterectomy* ; Oxycodone* ; Pain, Postoperative* ; Postoperative Care ; Visual Analog Scale

Breakthrough cancer pain is a transient exacerbation of pain that occurs despite relatively well controlled background pain with around-the-clock analgesia. It is highly prevalent in patients with cancer pain, with an overall prevalence of 70~90%. Breakthrough cancer pain has several negative effects on quality of life, including a decrease in functional status and social relationship, and higher incidence of anxiety/depression. It also places a detrimental burden on their families, society, and the healthcare system. According to the pathogenic mechanism, breakthrough cancer pain is classified into two categories: idiopathic (or spontaneous) pain and incident pain. Episodes of breakthrough cancer pain have typical characteristics, including rapid onset (5~10 min), severe intensity, and short duration (30~60 min). However, there are some variations in timing and severity of pain among patients and episodes. Therefore, a thorough assessment of pain episodes is needed and management plan must be individualized to provide optimal treatment. Several immediate-release formulations such as oxycodone, morphine, and hydromorphone are widely used despite relatively slow onset of action. Recent studies have shown that transmucosal fentanyl preparations were effective for faster control of breakthrough pain. We hope to improve management of breakthrough cancer pain with more efficient analgesics in line with currently available evidence.
Analgesia ; Analgesics ; Breakthrough Pain ; Delivery of Health Care ; Fentanyl ; Hope ; Humans ; Hydromorphone ; Incidence ; Morphine ; Oxycodone ; Prevalence ; Quality of Life