TY - JOUR
T1 - Oral oxycodone hydrochloride versus epidural anaesthesia for pain control after radical retropubic prostatectomy
AU - Hohwü, Lena
AU - Akre, Olof
AU - Bergenwald, Lennart
AU - Törnblom, Magnus
AU - Gustafsson, Ove
PY - 2006
Y1 - 2006
N2 - OBJECTIVE: To evaluate whether combined oral intake of paracetamol (4 x 1 g) + oxycodone hydrochloride (2x10 mg) is adequate and equivalent to epidural anaesthesia (EDA) with respect to postoperative pain control and postoperative mobilization after radical retropubic prostatectomy (RRP).MATERIAL AND METHODS: Forty consecutive patients scheduled for RRP were randomized to either: EDA with ropivacaine + paracetamol (4 x 1 g tablet) + injected or oral morphine on demand (EDA group); or infiltration of 25-40 ml of 0.25% bupivacaine into the wound + oxycodone hydrochloride (2 x 10 mg tablet) + paracetamol (4x1 g tablet) + injected or oral morphine on demand (OXY group). The groups were compared with respect to pain control determined by means of a visual analogue scale (VAS), time to free mobilization, hospital stay, complications, operation time and bleeding.RESULTS: Both analgesic regimens provided satisfactory analgesia, i.e. VAS scores remained significantly below 4 (p<0.0001). The EDA group experienced slightly less pain than the OXY group on the operation day but this was not significant: median VAS scores of 0.7 and 1.8, respectively (p=0.27). Median VAS scores during hospital stay were 1.7 in both treatment groups. VAS scores ranged from 0.1 to 3.3 and from 0.2 to 3.5 in the EDA and OXY groups, respectively. There was no significant difference in postoperative mobilization between the groups (p=0.06). The median duration of hospital stay was 3 nights in both groups.CONCLUSION: Postoperative pain control after RRP with oral oxycodone hydrochloride, paracetamol and extra morphine on demand is preferable to EDA when pain control as well as mobilization and costs are taken into account.
AB - OBJECTIVE: To evaluate whether combined oral intake of paracetamol (4 x 1 g) + oxycodone hydrochloride (2x10 mg) is adequate and equivalent to epidural anaesthesia (EDA) with respect to postoperative pain control and postoperative mobilization after radical retropubic prostatectomy (RRP).MATERIAL AND METHODS: Forty consecutive patients scheduled for RRP were randomized to either: EDA with ropivacaine + paracetamol (4 x 1 g tablet) + injected or oral morphine on demand (EDA group); or infiltration of 25-40 ml of 0.25% bupivacaine into the wound + oxycodone hydrochloride (2 x 10 mg tablet) + paracetamol (4x1 g tablet) + injected or oral morphine on demand (OXY group). The groups were compared with respect to pain control determined by means of a visual analogue scale (VAS), time to free mobilization, hospital stay, complications, operation time and bleeding.RESULTS: Both analgesic regimens provided satisfactory analgesia, i.e. VAS scores remained significantly below 4 (p<0.0001). The EDA group experienced slightly less pain than the OXY group on the operation day but this was not significant: median VAS scores of 0.7 and 1.8, respectively (p=0.27). Median VAS scores during hospital stay were 1.7 in both treatment groups. VAS scores ranged from 0.1 to 3.3 and from 0.2 to 3.5 in the EDA and OXY groups, respectively. There was no significant difference in postoperative mobilization between the groups (p=0.06). The median duration of hospital stay was 3 nights in both groups.CONCLUSION: Postoperative pain control after RRP with oral oxycodone hydrochloride, paracetamol and extra morphine on demand is preferable to EDA when pain control as well as mobilization and costs are taken into account.
KW - acetaminophen/administration & dosage
KW - administration, oral
KW - aged
KW - amides/administration & dosage
KW - analgesia, patient-controlled
KW - analgesics, opioid/administration & dosage
KW - anesthesia, epidural/adverse effects
KW - anesthetics, local/administration & dosage
KW - annalgesics, non-narcotic/administration & dosage
KW - bupivacaine/administration & dosage
KW - drug therapy, combination
KW - early ambulation
KW - humans
KW - male
KW - middle aged
KW - morphine/administration & dosage
KW - oxycodone/administration & dosage
KW - pain measurement
KW - pain, postoperative/drug therapy
KW - prostatectomy
KW - ropivacaine
KW - sufentanil/administration & dosage
U2 - 10.1080/00365590600589583
DO - 10.1080/00365590600589583
M3 - Journal article
C2 - 16809258
SN - 0036-5599
VL - 40
SP - 192
EP - 197
JO - Scandinavian Journal of Urology and Nephrology
JF - Scandinavian Journal of Urology and Nephrology
IS - 3
ER -