Efficacy of oxycodone in intravenous patient-controlled analgesia with different infusion modes after laparoscopic radical surgery of cervical cancer a prospective, randomized, double-blind study

Backgroud: The aim of this study was to compare the analgesic and adverse effects of oxycodone with 3 different infusion modes on postoperative pain after laparoscopic radical surgery of cervical cancer. Methods: Ninety patients undergoing laparoscopic radical surgery of cervical cancer were randomly divided into 3 groups: Group A (continuous infusion with 0.01mg/kg/h and a bolus dose with 0.03 mg/kg), Group B (a bolus dose with 0.03mg/kg) and Group C (PCA was administered as a time-scheduled decremental continuous infusion based on lean body mass). A blinded observer recorded Visual Analogue Scale (VAS), Ramsay sedation score (RSS), infused cumulative dose of oxycodone and side effects at 1, 6, 12, 24, and 48hours postoperatively, and satisfaction during the postoperative 48hours. Results: There were significant differences in the VAS pain score when resting or coughing among 3 groups at 1, 6 and 48hours postoperatively (P < .05). VAS was significantly higher in Group B than in Group A and C until postoperative 1, 6, and 48hours (P <. 05). There were significant differences in cumulative PCA dose among the 3 groups at 1 and 48hours postoperatively (P <. 05). Group C showed significantly less amount of cumulative PCA dose compared to other 2 groups at 1 hour, whereas cumulative PCA dose of Group A at 48hours was significantly more than other 2 groups (P <. 05). There were no significant differences in postoperative nausea and vomiting, FAS, muscle chilling score and RSS among 3 groups at 1, 6, 12, 24 and 48hours postoperatively. In addition, there was no difference in overall satisfaction during 48hours postoperatively among 3 groups. Conclusions: Oxycodone provides significant analgesic effect in 3 different infusion modes over 48hours after laparoscopic radical surgery of cervical cancer, and a time-scheduled decremental continuous infusion of oxycodone can become a better choice for patients after surgery of cervical cancer.