Controlled-release oxycodone is better tolerated than intravenous tramadol/metamizol for postoperative analgesia after retinal-surgery. Curr Eye Res 2004 Apr;28(4):271-5
Date
07/21/2004Pubmed ID
15259296DOI
10.1076/ceyr.28.4.271.27836Scopus ID
2-s2.0-1842833450 (requires institutional sign-in at Scopus site) 20 CitationsAbstract
PURPOSE: We assessed the clinical efficacy and tolerance of controlled-release oxycodone (CRO), comparing it with intravenous tramadol/metamizol combination in this prospective, randomised, double-blind study of 35 ASA physical status I-III patients undergoing retinal-surgery.
METHODS: General anaesthesia using remifentanil and propofol was performed for surgery. On arrival in the recovery room patients were randomly allocated to two groups. The controlled-release oxycodone group (CRO Group) received 10 mg CRO. 12 h after the initial dose another 10 mg CRO were administered. Simultaneously with the initial CRO dose, and every 4 h up to 24 h postoperatively, the CRO Group received intravenous isotonic saline infusion. On arrival in the recovery room the tramadol/metamizol group (TM Group) received a placebo tablet, and 12 h later a second placebo. Simultaneously 100 mg tramadol combined with 1 g metamizol were administered intravenously every 4 h until 24 h postoperatively. All patients had access to intravenous opioid rescue medication.
RESULTS: The AUC for quality of analgesia was significantly higher in the CRO Group than in the TM Group (p = 0.0023). Patient rated quality of analgesia significantly higher in the CRO Group than in the TM Group 8 h (p = 0.048), 16 h (p = 0.009) and 24 h (p = 0.001) postoperatively. There was no statistical difference in AUC for pain scores between groups (p = 0.205). The CRO Group experienced significantly less nausea than the TM Group (p = 0.012). Six patients in the TM Group in contrast to none in the CRO Group interrupted the study before finishing the study protocol (p = 0.022).
CONCLUSIONS: We conclude that CRO administered twice in the first 24 h postoperatively is superior to intravenous tramadol/metamizol for postoperative analgesia after retinal surgery, with fewer adverse events and greater patient satisfaction.
Author List
Kaufmann J, Yesiloglu S, Patermann B, Krombach J, Kiencke P, Kampe SAuthor
Jens Krombach MD Vice Chair, Director, Professor in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Analgesics, Opioid
Anti-Inflammatory Agents, Non-Steroidal
Delayed-Action Preparations
Dipyrone
Double-Blind Method
Drug Therapy, Combination
Female
Humans
Infusions, Intravenous
Male
Middle Aged
Ophthalmologic Surgical Procedures
Oxycodone
Pain, Postoperative
Prospective Studies
Retinal Diseases
Tramadol