Aim: The aim of this study was to assess the analgesic efficacy and safety of 1 mg and 0.5 mg oxycodone administration in a spinal block procedure for a total hip arthroplasty (THA).
Patients and Methods: Forty-two THA patients aged 59-81 with American Society Anesthesiology (ASA) II-III were included. All patients received anesthesia using spinal blockade, with bupivacaine 0.5% spinal heavy 2.5 ml, with 0.5 ml oxycodone hydrochloride 1.0 mg (group A; n = 28) or 0.5 mg (group B; n = 14). During surgery, each patient was sedated with 2-4 mg/kg/h intravenous propofol infusion. They received 100 mg intravenous ketoprofen at the end of the surgery at 8 pm and 8 am, with recommended doses every 12 h thereafter. Subcutaneous morphine 5 mg was used as a rescue analgesic, and the time to morphine use was recorded. After surgery, pain intensity (at the moment of patient report) was assessed using an 11-point numerical rating scale (NRS). The incidence of adverse effects was monitored. Blood samples were taken for assays of serum oxycodone, noroxycodone and bupivacaine levels.
Results: The time to rescue analgesia was 9.6 ± 5.6 h in group A and 7.3 ± 1.9 h in group B, and it did not differ between patient groups (P = 0.179). The mean NRS pain score was 4.5 in group A and 4.2 in group B. Three group A patients had detectable oxycodone levels: two < 7.1 ng/ml and in 1 spinal block induced anesthesia was unsuccessful and so he/she underwent general anesthesia (this patient was excluded from the analysis). Four group B patients had single values < 5 ng/ml. Noroxycodone levels were in all patients undetectable, and bupivacaine levels were 70-300 ng/ml. Regarding adverse effects, one patient had hypotension, one had bradycardia, and one had pruritus.
Conclusion: Oxycodone in spinal block prolongs analgesia period, does not cause serious adverse effects and seems to be safe and effective opioid for patients undergoing THA.
[http://dx.doi.org/10.1097/00003643-200309000-00002] [PMID: 12974588]
[http://dx.doi.org/10.1017/S0265021507002645] [PMID: 17892610]
[http://dx.doi.org/10.1097/00000542-197902000-00013] [PMID: 373503]
[http://dx.doi.org/10.1111/j.1600-0773.1992.tb00441.x] [PMID: 1508838]
[http://dx.doi.org/10.1111/bcp.13643] [PMID: 29782641]
[http://dx.doi.org/10.2147/JPR.S144799] [PMID: 29026333]
[http://dx.doi.org/10.2147/JPR.S125449] [PMID: 28496358]
[http://dx.doi.org/10.1111/j.1365-2125.1991.tb03942.x] [PMID: 1958450]
[http://dx.doi.org/10.2106/JBJS.N.00612] [PMID: 25653318]
[http://dx.doi.org/10.1016/j.clindermatol.2011.11.004] [PMID: 23245971]
[http://dx.doi.org/10.1097/00000542-198403000-00024] [PMID: 6546481]