Surgical Endoscopy

, Volume 22, Issue 10, pp 2220–2228

Preoperative administration of controlled-release oxycodone as a transition opioid for total intravenous anaesthesia in pain control after laparoscopic cholecystectomy

  • Guido Fanelli
  • Daniela Ghisi
  • Marco Berti
  • Raffaella Troglio
  • Andrea Ortu
  • Camilla Consigli
  • Andrea Casati
Article

DOI: 10.1007/s00464-008-0026-6

Cite this article as:
Fanelli, G., Ghisi, D., Berti, M. et al. Surg Endosc (2008) 22: 2220. doi:10.1007/s00464-008-0026-6

Abstract

Background

The complexity of pain from laparoscopic cholecystectomy and the need for treating incident pain provide rationale for multipharmacological analgesia. We investigated the preoperative administration of controlled-release (CR) oxycodone as transition opioid from remifentanil infusion for pain after laparoscopic cholecystectomy.

Methods

Fifty consecutive patients undergoing laparoscopic cholecystectomy were randomly, double-blindly assigned to treatment group (n = 25, CR oxycodone: 1 h before surgery and 12 h after the first administration) or to the control group (n = 25, placebo: administered at the same intervals). General anaesthesia was maintained with propofol and remifentanil target-controlled infusions (TCIs). All patients received ketorolac 30 mg i.v. Tramadol i.v. was administered for patient-controlled analgesia (PCA) postoperatively. Numerical rating scale for pain at rest and at movement (NRSr and NRSi), tramadol consumption, times to readiness to surgery and awakening, times to modified Aldrete’s and modified Post-Anesthetic Discharge Scoring System (PADSS) >9 and side effects were evaluated.

Results

All NRSr and NRSi and tramadol consumption were significantly lower in the treatment group. The oxycodone group showed higher modified Aldrete’s scores at each time and reached a PADSS >9 faster. Side effects and postoperative nausea and vomiting episodes were comparable.

Conclusions

We demonstrated the success of a multipharmacological treatment including opioid premedication with CR oxycodone used as transition opioid for TCI remifentanil infusion; the treatment group showed lower pain scores and rescue analgesic consumption, shorter time to discharge from recovery room and from surgical ward, and the same incidence of side effects, comparably to controls.

Keywords

CholecystectomyPainAnaesthesiaClinical papers/trials/researchRemifentanil target-controlled infusionCR oxycodone

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Guido Fanelli
    • 1
    • 1
  • Daniela Ghisi
    • 1
  • Marco Berti
    • 1
  • Raffaella Troglio
    • 1
  • Andrea Ortu
    • 1
  • Camilla Consigli
    • 1
  • Andrea Casati
    • 1
  1. 1.Department of Anaesthesia, Intensive Care and Pain TherapyUniversity Hospital of ParmaParmaItaly