Table 2.
Characteristics of included studies
| References (year) | Country | Type of surgery | No. of patients in the main analysis set | Study duration | Route of administration | PCA program parameters | Drugs administered | Dose conversion ratioa (oxycodone: fentanyl or morphine or sufentanil) | Reported outcomes |
|---|---|---|---|---|---|---|---|---|---|
| Oxycodone vs. fentanyl | |||||||||
| Kim et al. (2017) [34] | Republic of Korea | Laparoscopic hysterectomy | 127 | 48 h | IV-PCA |
Oxycodone Bolus dose: 0.5 ml Rate of infusion: continuous; 1050 mcg/h Lockout interval: 15 min Fentanyl Bolus dose: 0.5 ml Rate of infusion: continuous; 14 mg/h Lockout interval: 15 min |
100 ml mixture of 52.5 mg oxycodone or 700 mcg fentanyl, 150 mg ketorolac, and 0.6 mg ramosetron with NS solution | 75:1 |
Efficacy: pain intensity—at rest, on coughing; analgesic consumption; use of additional analgesics Safety: nausea, vomiting, sedation, dizziness, drowsiness, headache, pruritus, respiratory depression Patient satisfaction |
| Ding et al. (2016) [36] | China | Gastrointestinal laparotomy | 56 | 48 h | IV-PCA |
Oxycodone Bolus dose: 1 ml Rate of infusion: continuous; 1-2 ml/h Lockout interval: 15 min Fentanyl Bolus dose: 0.5 ml Rate of infusion: continuous; 1-2 ml/h Lockout interval: 15 min |
100 ml mixture of 0.7 mg/kg oxycodone or 12 mcg/kg fentanyl, 180 mg ketorolac, 0.125 mg palonosetron with NS solution | 60:1 |
Efficacy: pain intensity—at rest, upon movement; analgesic consumption; use of additional analgesics Safety: nausea, vomiting, sedation, dizziness, respiratory rate, respiratory depression Patient satisfaction |
| Kim et al. (2015) [33] | Republic of Korea | Laparoscopic hysterectomy | 60 | 48 h | IV-PCA |
Oxycodone Bolus dose: 0.5 ml Rate of infusion: continuous; 1.4 mg/h Lockout interval: 15 min Fentanyl Bolus dose: 0.5 ml Rate of infusion: continuous; 14 mcg/h Lockout interval: 15 min |
100-ml mixture of 70 mg oxycodone or 700 mcg fentanyl, 150 mg ketorolac, and 0.6 mg ramosetron with NS solution | 100:1 |
Efficacy: pain intensity—at rest, while coughing; analgesic consumption; use of additional analgesics Safety: nausea, vomiting, headache, sedation, dizziness, pruritus, respiratory depression Patient satisfaction |
| Park et al. (2015) [35] | Republic of Korea | Laparoscopic hysterectomy or laparoscopic myomectomy | 69 | 48 h | IV-PCA |
Oxycodone Bolus dose: 0.9 mg Rate of infusion: continuous; 0.9 mg/h Lockout interval: 15 min Fentanyl Bolus dose: 15 mcg Rate of infusion: continuous; 15 mcg/h Lockout interval: 15 min |
Oxycodone (bolus dose 0.9 mg) or fentanyl (bolus dose 15 mcg), and 0.075 mg palonosetron | 60:1 |
Efficacy: pain intensity—at rest, on moving; analgesic consumption Safety: nausea, vomiting, headache, sedation, dizziness Patient satisfaction |
| Hwang et al. (2014) [31] | Republic of Korea | Laparoscopic cholecystectomy | 81 | 48 h | IV-PCA |
Oxycodone Bolus dose: 1 ml (4 h limit of 40 ml) Rate of infusion: nil Lockout interval: 6 min Fentanyl Bolus dose: 1 ml (four hour limit of 40 ml) Rate of infusion: nil Lockout interval: 6 min |
3 mg oxycodone or 30 mcg fentanyl, and 4.5 mg ketorolac | 100:1 |
Efficacy: pain intensity—at rest, during coughing; analgesic consumption Safety: nausea, vomiting, headache, shivering, pruritus, respiratory depression, sedation Patient satisfaction |
| Koch et al. (2008) [30] | Denmark | Laparoscopic cholecystectomy | 73 | 30 min to discharge | IV bolus | – | 10 mg oxycodone or 100 mcg fentanyl | 100:1 |
Efficacy: pain intensity—overall, on coughing, abdominal; analgesic consumption; pressure tolerance thresholds Safety: nausea, vomiting, sedation |
| Oxycodone vs. morphine | |||||||||
| Pedersen (2013) [37] | Denmark | Percutaneous nephrolithotomy surgery | 44 | 4 h | IV | – | IV oxycodone or morphine 0.1 mg/kg | 1:1 |
Efficacy: pain intensity—overall; analgesic consumption—time to first dose, dose Safety: nausea, vomiting, dizziness, sedation, itching, respiratory effects, use of anti-emetics |
| Lenz et al. (2009) [32] | Norway | Laparoscopic supracervical hysterectomy or laparoscopic total hysterectomy | 91 | 24 h | IV-PCA |
Oxycodone Bolus dose: 0.015 mg/kg Rate of infusion: nil Lockout interval: 5 min Morphine Bolus dose: 0.015 mg/kg Rate of infusion: nil Lockout interval: 5 min |
IV oxycodone or morphine 0.015 mg/kg | 1:1 |
Efficacy: pain intensity—at rest, during coughing; analgesic consumption—time to first dose Safety: post-operative nausea and vomiting, sedation, itching |
| Oxycodone vs. sufentanil | |||||||||
| Han et al. (2018) [40] | China | Elective abdominal surgery (laparotomy or endoscopy) | 48 h | 120 | IV-PCA |
Oxycodone Bolus dose: 2 mg Rate of infusion: nil Lockout interval: 5 min Sufentanil Bolus dose: 2 mcg Rate of infusion: 0.02 mcg/kg/h Lockout interval: 5 min |
Oxycodone 0.1 mg/kg (endoscopy) or 0.15 mg/kg (laparotomy) or sufentanil 0.1 mcg/kg (endoscopy) or 0.15 mcg/kg (laparotomy) | 1000:1 |
Efficacy: pain intensity; analgesic consumption—number of PCA boluses, number of bolus times pressed by patients, time to first dose; rescue analgesic dose; functional activity score Safety: nausea, vomiting, pruritus, respiratory depression Patient satisfaction |
| Nie et al. (2017) [38] | China | Cesarean section | 24 h | 117 | IV-PCA |
Oxycodone Bolus dose: 2 ml Rate of infusion: continuous; 1 ml/h Lockout interval: 15 min Sufentanil 70 mcg/oxycodone 30 mg Bolus dose: 2 ml Rate of infusion: continuous; 1 ml/h Lockout interval: 15 min Sufentanil 50 mcg/oxycodone 50 mg Bolus dose: 2 ml Rate of infusion: continuous; 1 ml/h Lockout interval: 15 min Sufentanil Bolus dose: 2 ml Rate of infusion: continuous; 1 ml/h Lockout interval: 15 min |
100 ml mixture of oxycodone 100 mg, sufentanil 70 mcg/oxycodone 30 mg, sufentanil 50 mcg/oxycodone 50 mg, or sufentanil 100 mcg, and 0.3 mg ramosetron | 1000:1 |
Efficacy: pain intensity—uterine cramping pain, at rest, moving into sitting position; analgesic consumption Safety: nausea, vomiting, dizziness, pruritus, respiratory depression, hypotension, hypoxemia, sedation Patient satisfaction |
| Wang et al. (2016) [39] | China | Laparoscopic radical gastrectomy | 48 h | 50 | IV-PCA |
Oxycodone Bolus dose: 0.02 mg/kg Rate of infusion: nil Lockout interval: 10 min Sufentanil Bolus dose: 0.04 mcg/kg Rate of infusion: nil Lockout interval: 10 min |
Oxycodone 0.02 mg/kg or sufentanil 0.04 mcg/kg | 500:1 |
Efficacy: pain intensity—on coughing, at rest Safety: nausea, vomiting, dizziness, sedation, itching Patient satisfaction |
IV, intravenous; IV-PCA, intravenous patient-controlled analgesia; mcg, microgram; NS, normal saline
aCalculated based on relative doses used