Oxycodone/naloxone in postoperative pain management of surgical patients

2018 ◽  
Vol 14 (1) ◽  
pp. 52 ◽  
Author(s):  
Ioannis D. Gkegkes, MD, PhD ◽  
Evelyn Eleni Minis, MD ◽  
Christos Iavazzo, MD, MSc, PhD

Background: The role of analgesia is crucial in the management of postoperative pain. Different combinations of oral analgesics have been proposed in the past. The oxycodone/naloxone (OXN) combination is a recent addition and is being used by different surgical specialties. The aim of our study was to clarify the possible role, advantages, and disadvantages of OXN in the pain management of surgical patients.Method: The authors retrieved the included studies after performing a systematic search in PubMed and Scopus.Results: Ten studies (six randomized controlled trials, three retrospective studies, and a prospective study) were eligible for inclusion in this review. In total, 1,996 patients were included. Six studies reported on orthopedic procedures while four studies referred to colorectal, gynecologic, cardiac, and thoracic surgery procedures, respectively. The analgesic effect of OXN was evaluated in nine out of 10 studies, where OXN showed superiority only in two out of nine studies. Postoperative bowel function was evaluated in seven out of 10 studies. Patients treated with OXN did not show any significant differences in bowel function when compared to control groups. No superiority was found regarding the possible adverse events.Conclusion: Analgesia is crucial to postoperative recovery. Pain control can be achieved a combination of different analgesics, including OXN. This oral analgesic combination can have the potential to minimize side effects, such as opioid-induced constipation and optimize the recovery period.

2020 ◽  
Vol 219 (1) ◽  
pp. 8-14
Author(s):  
Kristen E. Limbach ◽  
SuEllen J. Pommier ◽  
Kristen P. Massimino ◽  
Rodney F. Pommier ◽  
Arpana M. Naik

Medicina ◽  
2018 ◽  
Vol 54 (2) ◽  
pp. 20 ◽  
Author(s):  
David Gelman ◽  
Arūnas Gelmanas ◽  
Dalia Urbanaitė ◽  
Ramūnas Tamošiūnas ◽  
Saulius Sadauskas ◽  
...  

Enhanced recovery after surgery (ERAS) are specially designed multimodal perioperative care pathways which are intended to attain and improve rapid recovery after surgical interventions by supporting preoperative organ function and attenuating the stress response caused by surgical trauma, allowing patients to get back to normal activities as soon as possible. Evidence-based protocols are prepared and published to implement the conception of ERAS. Although they vary amongst health care institutions, the main three elements (preoperative, perioperative, and postoperative components) remain the cornerstones. Postoperative pain influences the quality and length of the postoperative recovery period, and later, the quality of life. Therefore, the optimal postoperative pain management (PPM) applying multimodal analgesia (MA) is one of the most important components of ERAS. The main purpose of this article is to discuss the concept of MA in PPM, particularly reviewing the use of opioid-sparing measures such as paracetamol, nonsteroid anti-inflammatory drugs (NSAIDs), other adjuvants, and regional techniques.


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