Abstract
This randomized, controlled study compared the efficacy and safety between oxycodone–paracetamol tablet and celecoxib for postoperative analgesia in patients who underwent arthroscopic knee surgery (AKS). Totally, 232 patients scheduled to undergo AKS were enrolled and were randomly assigned to either the oxycodone–paracetamol (OPT group) or the celecoxib group (CEL group). Pain at rest/motion (based on pain visual analog scale (VAS) score), rescue analgesia consumption, satisfaction level and adverse events were assessed after AKS. Pain VAS score at rest was decreased at 6 h, 12 h post-AKS in the OPT group compared with the CEL group. Similarly, pain VAS score at motion was reduced at 6 h, 12 h, 24 h post-AKS in the OPT group compared to the CEL group. Furthermore, both rescue analgesia rate (14.7% vs. 33.6%) and accumulated pethidine consumption (3.7 ± 8.9 mg vs. 14.0 ± 21.2 mg) were lower in OPT group compared with the CEL group. Patients satisfaction score was either at 24 h, 48 h in OPT group compared with the CEL group. Further subgroup analyses indicated that the effect of oxycodone–paracetamol versus (vs. celecoxib) on post-AKS management was more apparent in the elderly patients and male patients. In addition, the adverse events were well tolerable (including nausea, constipation, vomiting, drowsiness and dizziness) and were of no different between the two groups. In conclusion, oxycodone–paracetamol tablet presents increased analgesic efficacy for acute postoperative pain, with higher patient satisfaction and comparable safety profiles compared with celecoxib in patients underwent AKS.
Similar content being viewed by others
References
Akinbade AO, Ndukwe KC, Owotade FJ (2019) Comparative analgesic efficacy and tolerability of celecoxib and tramadol on postoperative pain after mandibular third molar extraction: a double blind randomized controlled trial. Niger J Clin Pract 22:796–800. https://doi.org/10.4103/njcp.njcp_544_18
Bali A, Randhawa PK, Jaggi AS (2015) Stress and opioids: role of opioids in modulating stress-related behavior and effect of stress on morphine conditioned place preference. Neurosci Biobehav Rev 51:138–150. https://doi.org/10.1016/j.neubiorev.2014.12.018
Barrett T, Kostenbader K, Nalamachu S, Giuliani M, Young JL (2016) Safety and tolerability of biphasic immediate-release/extended-release oxycodone/acetaminophen tablets: analysis of 11 clinical trials. Pain Pract 16:856–868. https://doi.org/10.1111/papr.12324
Bekhit MH (2015) Profile of extended-release oxycodone/acetaminophen for acute. Pain J Pain Res 8:719–728. https://doi.org/10.2147/JPR.S73567
Carr AJ, Price AJ, Glyn-Jones S, Rees JL (2015) Advances in arthroscopy-indications and therapeutic applications. Nat Rev Rheumatol 11:77–85. https://doi.org/10.1038/nrrheum.2014.174
Chavez TJ, Garvey KD, Collins JE, Lowenstein NA, Matzkin EG (2020) Resilience as a predictor of patient satisfaction with nonopioid pain management and patient-reported outcome measures after knee arthroscopy. Arthroscopy 36:2195–2201. https://doi.org/10.1016/j.arthro.2020.03.013
Cunningham D, Lewis B, Hutyra C, Nho S, Olson S, Mather R (2018) Prospective, observational study of opioid use after hip arthroscopy for femoroacetabular impingement syndrome. Arthroscopy 34:1488-1497.e1486. https://doi.org/10.1016/j.arthro.2017.12.005
Dart RC, Surratt HL, Cicero TJ, Parrino MW, Severtson SG, Bucher-Bartelson B, Green JL (2015) Trends in opioid analgesic abuse and mortality in the United States. N Engl J Med 372:241–248. https://doi.org/10.1056/NEJMsa1406143
El Tumi H, Johnson MI, Dantas PBF, Maynard MJ, Tashani OA (2017) Age-related changes in pain sensitivity in healthy humans: a systematic review with meta-analysis. Eur J Pain 21:955–964. https://doi.org/10.1002/ejp.1011
Friberger Pajalic K, Turkiewicz A, Englund M (2018) Update on the risks of complications after knee arthroscopy. BMC Musculoskelet Disord 19:179. https://doi.org/10.1186/s12891-018-2102-y
Gammaitoni AR, Galer BS, Bulloch S, Lacouture P, Caruso F, Ma T, Schlagheck T (2003) Randomized, double-blind, placebo-controlled comparison of the analgesic efficacy of oxycodone 10 mg/acetaminophen 325 mg versus controlled-release oxycodone 20 mg in postsurgical pain. J Clin Pharmacol 43:296–304. https://doi.org/10.1177/0091270003251147
Gaskell H, Derry S, Moore RA, McQuay HJ (2009) Single dose oral oxycodone and oxycodone plus paracetamol (acetaminophen) for acute postoperative pain in adults. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD002763.pub2
Gazendam A, Ekhtiari S, Horner NS, Nucci N, Dookie J, Ayeni OR (2020) Perioperative nonopioid analgesia reduces postoperative opioid consumption in knee arthroscopy: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-020-06256-2
He Y, He H, Xie DX, Li X, Wang Y (2020) Comparative efficacy and safety of intra-articular analgesics after knee arthroscopy: a bayesian network meta-analysis protocol. BMJ Open 10:e035346. https://doi.org/10.1136/bmjopen-2019-035346
Kamdar PM et al (2020) Opioid use after knee arthroscopy. Arthrosc Sports Med Rehabil 2:e77–e81. https://doi.org/10.1016/j.asmr.2019.11.003
Karcioglu O, Topacoglu H, Dikme O, Dikme O (2018) A systematic review of the pain scales in adults: which to use? Am J Emerg Med 36:707–714. https://doi.org/10.1016/j.ajem.2018.01.008
Li JW, Ma YS, Xiao LK (2019) Postoperative pain management in total knee arthroplasty. Orthop Surg 11:755–761. https://doi.org/10.1111/os.12535
Lu W, Zhao S, Gong M, Sun L, Ding L (2018) Simultaneous determination of acetaminophen and oxycodone in human plasma by LC–MS/MS and its application to a pharmacokinetic study. J Pharm Anal 8:160–167. https://doi.org/10.1016/j.jpha.2018.01.006
Mardani-Kivi M, Karimi Mobarakeh M, Haghighi M, Naderi-Nabi B, Sedighi-Nejad A, Hashemi-Motlagh K, Saheb-Ekhtiari K (2013) Celecoxib as a pre-emptive analgesia after arthroscopic knee surgery; a triple-blinded randomized controlled trial. Arch Orthop Trauma Surg 133:1561–1566. https://doi.org/10.1007/s00402-013-1852-0
Maurer AJ, Lissounov A, Knezevic I, Candido KD, Knezevic NN (2016) Pain and sex hormones: a review of current understanding. Pain Manag 6:285–296. https://doi.org/10.2217/pmt-2015-0002
Mitra S, Carlyle D, Kodumudi G, Kodumudi V, Vadivelu N (2018) New advances in acute postoperative pain management. Curr Pain Headache Rep 22:35. https://doi.org/10.1007/s11916-018-0690-8
Mobini A, Mehra P, Chigurupati R (2018) Postoperative pain and opioid analgesic requirements after orthognathic surgery. J Oral Maxillofac Surg 76:2285–2295. https://doi.org/10.1016/j.joms.2018.05.014
Onda A, Ogoshi A, Itoh M, Nakagawa T, Kimura M (2016) Comparison of the effects of treatment with celecoxib, loxoprofen, and acetaminophen on postoperative acute pain after arthroscopic knee surgery: a randomized, parallel-group trial. J Orthop Sci 21:172–177. https://doi.org/10.1016/j.jos.2015.11.005
Pham H et al (2019) The utility of oral nonsteroidal anti-inflammatory drugs compared with standard opioids following arthroscopic meniscectomy: a prospective observational study. Arthroscopy 35:864-870.e861. https://doi.org/10.1016/j.arthro.2018.09.018
Stessel B, Theunissen M, Fiddelers AA, Joosten EA, Kessels AG, Gramke HF, Marcus MA (2014) Controlled-release oxycodone versus naproxen at home after ambulatory surgery: a randomized controlled trial. Curr Ther Res Clin Exp 76:120–125. https://doi.org/10.1016/j.curtheres.2014.10.001
Tintara H, Voradithi P, Choobun T (2018) Effectiveness of celecoxib for pain relief and antipyresis in second trimester medical abortions with misoprostol: a randomized controlled trial. Arch Gynecol Obstet 297:709–715. https://doi.org/10.1007/s00404-018-4653-4
Wang YL et al (2015) Single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery: a meta-analysis of randomised placebo-controlled studies. BMJ Open 5:e006815. https://doi.org/10.1136/bmjopen-2014-006815
Wang SC, Chen YC, Lee CH, Cheng CM (2019) Opioid addiction, genetic susceptibility, and medical treatments: a review. Int J Mol Sci. https://doi.org/10.3390/ijms20174294
Webster LR, Bath B, Medve RA (2009) Opioid formulations in development designed to curtail abuse: who is the target? Expert Opin Investig Drugs 18:255–263. https://doi.org/10.1517/13543780902751622
Zhu X (2020) Efficacy of preemptive analgesia versus postoperative analgesia of celecoxib on postoperative pain, patients’ global assessment and hip function recovery in femoroacetabular impingement patients underwent hip arthroscopy surgery. Inflammopharmacology 28:131–137. https://doi.org/10.1007/s10787-019-00648-8
Acknowledgements
This study was supported by Youth Foundation of Health commission of Hebei Province (No. 20150280).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Liu, J., Di, J., Zhang, Y. et al. Oxycodone–paracetamol tablet exhibits increased analgesic efficacy for acute postoperative pain, higher satisfaction and comparable safety profiles compared with celecoxib in patients underwent arthroscopic knee surgery. Inflammopharmacol 29, 1091–1099 (2021). https://doi.org/10.1007/s10787-021-00828-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10787-021-00828-5