Safety and efficacy of intravenous oxycodone in geriatric patients undergoing general anesthesia for ophthalmic surgeries:a randomized controlled trial

BackgroundThe present study aimed to compare the safety and efficacy of intravenous oxycodone with fentanyl in geriatric patients undergoing general anesthesia for ophthalmic surgeries.Methods107 geriatric patients (age 65-79 years old) with the ASA physical status 1 or 2 undergoing general anesthesia for glaucoma or retina surgeries between May 2016 and November 2017 were divided into three groups: Group O1, Group O2, and Group F. After exclusion, 105 patients were included for the final analysis, with 35 patients in each group. Oxycodone (0.1 mg/kg in Group O1, or 0.2 mg/kg in Group O2) or fentanyl (2 mcg/kg in Group F) was administered intravenously during induction of general anesthesia. Patient demographics, surgical time and anesthesia time, perioperative hemodynamic parameters and requirement of vasoactive medication, postoperative pain and requirement of rescue analgesics, postoperative sedation level and recovery time, and perioperative complications were recorded.ResultsPatients in Group O1 experienced less clinically significant hypotension compared to either Group F or Group O2. Consistently, patients in Group O1 required less intraoperative vasoactive medication (ephedrine) than those in Group F. The postoperative pain on extubation was more severe and more patients required rescue analgesia in Group F compared to Group O2, but not Group O1. The recovery time was longer and sedation level was higher in Group O2 than Group F or O1. The incidence of hypoxia during postoperative recovery was higher in Group O2 than Group F or O1.ConclusionOxycodone at 0.1mg/kg can be a safe and effective application for geriatric patients undergoing general anesthesia for ophthalmic surgeries, with adequate pain control and less side effects.