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BJA Advance Access published online on June 25, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aeh218
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
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Accepted March 13, 2004

Clinical Investigation

Epidural oxycodone or morphine following gynaecological surgery{dagger}

F. Yanagidate 1 S. Dohi 1*

1 Department of Anesthesiology and Pain Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, Gifu 501-1194, Japan

* To whom correspondence should be addressed. E-mail: shu-dohi{at}cc.gifu-u.ac.jp.


  Abstract

Background. The analgesic action of oxycodone is of rapid onset, in contrast to morphine, and is mediated by kappa-opioid receptors of the spinal cord. We compared analgesia and side-effects of epidural oxycodone with those of morphine after gynaecological surgery.

Methods. We studied prospectively in 75 women in a double-blind, randomized manner: epidural morphine 6 mg day-1 (n=25), epidural oxycodone 6 mg day-1 (n=25) and epidural oxycodone 12 mg day-1 (n=25). All patients underwent gynaecological surgery under general (isoflurane and nitrous oxide) and epidural anaesthesia. Visual analogue scale (VAS) pain scores at rest and on coughing, verbal descriptive scale (VDS) satisfaction scores, sedation scores, pruritus scores and nausea/vomiting scores were recorded for 3 days after surgery.

Results. VAS pain scores at rest in patients who received oxycodone 6 mg day-1 were higher than in patients who received morphine 6 mg day-1 at 6 h and on the first postoperative day and were significantly higher than in patients who received oxycodone 12 mg day-1 on the first postoperative day. Scores for nausea, vomiting and pruritus in patients who received oxycodone 6 mg day-1 and 12 mg day-1 were lower than those in patients who received morphine. No significant differences were seen in VAS at cough and VDS satisfaction scores between the three groups.

Conclusion. Epidural oxycodone was as effective as morphine at the doses investigated, with fewer side-effects.

Keywords: anaesthetic techniques, epidural; analgesia, postoperative; analgesic techniques, extradural; analgesics, opioid, morphine; analgesics, opioid, oxycodone.

{dagger} Part of this study was presented at the Annual Meeting of the Japan Society of Anesthesiologists in Tokyo, Japan, April 6-8, 2000. The study was supported in part by research grants no. 12557129 and 14770765 from the Ministry of Education, Science, and Culture of Japan.


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