Controlled-release oxycodone versus naproxen at home after ambulatory surgery: a randomized controlled trial.

Autor:	Stessel B; Department of Anesthesiology, Maastricht University Medical Center+, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands ; Current affiliation: Department of Anesthesiology and Pain Treatment, Jessa Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium., Theunissen M; Department of Anesthesiology, Maastricht University Medical Center+, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands., Fiddelers AA; Department of Anesthesiology, Maastricht University Medical Center+, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands., Joosten EA; Department of Anesthesiology, Maastricht University Medical Center+, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands., Kessels AG; Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center+, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands., Gramke HF; Department of Anesthesiology, Maastricht University Medical Center+, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands., Marcus MA; Department of Anesthesiology, Maastricht University Medical Center+, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands ; Current affiliation: Department of Anesthesia/ICU, Pain, and Palliative Care, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
Jazyk:	angličtina
Zdroj:	Current therapeutic research, clinical and experimental [Curr Ther Res Clin Exp] 2014 Nov 28; Vol. 76, pp. 120-5. Date of Electronic Publication: 2014 Nov 28 (Print Publication: 2014).
DOI:	10.1016/j.curtheres.2014.10.001
Abstrakt:	Background: Strong opioids in the home setting after ambulatory surgery have rarely been studied for fear of hazardous adverse effects such as respiratory depression. Objectives: We compared the efficacy of paracetamol/controlled-release (CR) oxycodone and paracetamol/naproxen for treatment of acute postoperative pain at home after ambulatory surgery. Secondary outcomes were adverse effects of study medication, treatment satisfaction, and postoperative analgesic compliance. Methods: Patients undergoing ambulatory knee arthroscopy or inguinal hernia repair surgery (n = 105) were randomized into 3 groups: Group1 paracetamol/naproxen (n = 35), Group 2 paracetamol/CR oxycodone for 24 hours (n = 35), and Group 3 paracetamol/CR oxycodone for 48 hours (n = 35). Pain intensity at movement and at rest using a visual analog scale as well as satisfaction with postoperative analgesia and side effects were recorded for up to 48 hours postoperatively. Compliance with study medication was also assessed. Results: For pain at movement and at rest, no significant differences were found between the paracetamol/naproxen group and either the paracetamol/CR oxycodone for 24 hours group (β = 2.6 [4.9]; P = 0.597) or the paracetamol/CR oxycodone for 48 hours (β = -1.7 [5.1]; P = 0.736). No major adverse effects of study medication were registered and satisfaction with postoperative pain treatment was high in all groups. Compliance was comparable across the groups. Despite clear instructions, 8 patients with the lowest pain scores did not use any of the prescribed pain medication. Conclusions: Paracetamol/CR oxycodone and paracetamol/naproxen are equally effective in treatment of acute postoperative pain at home after ambulatory surgery with comparable patient satisfaction level. We suggest paracetamol/CR oxycodone to be a valuable alternative for the current paracetamol/naproxen gold standard, particularly in patients with a contraindication for nonsteroidal anti-inflammatory drugs. ClinicalTrials.gov identifier: NCT02152592.
Databáze:	MEDLINE
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