Supervisor：Ministry of Education of the People's Republic of ChinaSponsor：Sichuan University Editor-in-chief：LI Youping Publishing period：
Monthly
ISSN：1672-2531CN：51–1656/R
ObjectiveTo systematically review the efficacy and safety of oxycodone versus morphine for postoperative intravenous self-control analgesia (PCIA). MethodsWe searched databases including PubMed, EMbase, The Cochrane Library (Issue 8, 2015), CBM, CNKI, VIP, WanFang Data from inception to August 2015, to collect randomized controlled trials (RCTs) about oxycodone versus morphine for postoperative PCIA. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.ResultsSeven RCTs involving 826 patients were included. The results of meta-analysis showed that: there were no significant differences in postoperative analgesia at the points of 2 h, 3 h, 4 h, 8 h, 12 h, 24 h, 36 h and 48 h after surgery (2 h: MD=0.20, 95%CI –0.18 to 0.58, P=0.30; 3 hresting state: MD=–0.51, 95%CI –2.27 to 1.26, P=0.57; 3 hdynamic state: MD=–0.46, 95%CI –2.23 to 1.40, P=0.63; 4 h: MD=0.00, 95%CI –0.25 to 0.25, P=0.99; 8 h: MD=0.10, 95%CI –0.16 to 0.36, P=0.46; 12 h: MD=–0.34, 95%CI –0.85 to 0.17, P=0.19; 24 h: MD=–0.13, 95%CI –0.43 to 0.17, P=0.41; 36 h: MD=0.10, 95%CI –0.28 to 0.48, P=0.60; 48 h: MD=–0.13, 95%CI –0.36 to 0.09, P=0.25). The incidences of postoperative vomiting (OR=0.23, 95%CI 0.08 to 0.63, P=0.005), nausea (OR=0.27, 95%CI 0.08 to 0.86, P=0.03), respiratory depression (OR=0.15, 95%CI 0.04 to 0.53, P=0.003) and skin pruritus (OR=0.19, 95%CI 0.05 to 0.66, P=0.009) in the oxycodone group were lower than those in the morphine group. In addition, there were no significant differences of the incidences of headache, dizzy and shiver between two groups.ConclusionCompared with morphine, oxycodone has the same analgesia effect for PCIA, however, the incidences of adverse reactions are lower. Due to the limited quality and quantity of included studies, the above results are needed to be validated by more high quality studies.
Citation：LIU Wei, LV Huangwei. Efficacy and safety of oxycodone versus morphine for postoperative intravenous self-control analgesia: a systematic review. Chinese Journal of Evidence-Based Medicine, 2017, 17(6): 692-697. doi: 10.7507/1672-2531.201606018Copy
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Park JH, Lee C, Shin Y, et al. Comparison of oxycodone and fentanyl for postoperative patient-controlled analgesia after laparoscopic gynecological surgery. Korean J Anesthesiol, 2015, 68(2): 153-158.
Lenz H, Sandvik L, Qvigstad E, et al. A comparison of intravenous oxycodone and intravenous morphine in patient-controlled postoperative analgesia after laparoscopic hysterectomy. Anesth Analg, 2009, 109(4): 1279-1283.
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Backlund M, Lindgren L, Kajimoto Y, et al. Comparison of epidural morphine and oxycodone for pain after abdominal surgery. J Clin Anesth, 1997, 9(1): 30-35.
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P?yhi? R, Sepp?l? T, Olkkola KT, et al. The pharmacokinetics and metabolism of oxycodone after intramuscular and oral administration to healthy subjects. Br J Clin Pharmacol 1992, 33(6): 617-621.
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Leow KP, Cramond T, Smith MT. Pharmacokinetics and pharmacodynamics of oxycodone when given intravenously and rectally to adult patients with cancer pain. Anesth Analg, 1995, 80(2): 296-302.
3. Park JH, Lee C, Shin Y, et al. Comparison of oxycodone and fentanyl for postoperative patient-controlled analgesia after laparoscopic gynecological surgery. Korean J Anesthesiol, 2015, 68(2): 153-158.
11. Lenz H, Sandvik L, Qvigstad E, et al. A comparison of intravenous oxycodone and intravenous morphine in patient-controlled postoperative analgesia after laparoscopic hysterectomy. Anesth Analg, 2009, 109(4): 1279-1283.
12. Takala A, Kaasalainen V, Sepp?l? T, et al. Pharmacokinetic comparison of intravenous and intranasal administration of oxycodone. Acta Anaesthesiol Scand, 1997, 41(2): 309-312.
13. Yanagidate F, Dohi S. Epidural oxycodone or morphine following gynaecological surgery. Br J Anaesth, 2004, 93(3): 362-367.
14. Backlund M, Lindgren L, Kajimoto Y, et al. Comparison of epidural morphine and oxycodone for pain after abdominal surgery. J Clin Anesth, 1997, 9(1): 30-35.
15. P?yhi? R, Sepp?l? T, Olkkola KT, et al. The pharmacokinetics and metabolism of oxycodone after intramuscular and oral administration to healthy subjects. Br J Clin Pharmacol 1992, 33(6): 617-621.
16. Leow KP, Cramond T, Smith MT. Pharmacokinetics and pharmacodynamics of oxycodone when given intravenously and rectally to adult patients with cancer pain. Anesth Analg, 1995, 80(2): 296-302.
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Citation：LIU Wei, LV Huangwei. Efficacy and safety of oxycodone versus morphine for postoperative intravenous self-control analgesia: a systematic review. Chinese Journal of Evidence-Based Medicine, 2017, 17(6): 692-697. doi: 10.7507/1672-2531.201606018
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