Key result
Intravenous oxycodone at 0.1 mg/kg resulted in a similar PACU length of stay compared to fentanyl (32.94 vs 35.09 min), while a 0.2 mg/kg dose significantly prolonged PACU stay (42.80 min, p<0.05).
Why the study?
The safety and efficacy of intravenous oxycodone compared with fentanyl needed evaluation in geriatric patients undergoing general anesthesia for ophthalmic surgeries.
Does intravenous oxycodone improve PACU length of stay and hemodynamic stability compared to fentanyl in geriatric patients undergoing general anesthesia for ophthalmic surgeries?
RCT (n=105)
Double-blind
Computer randomization program
No
Does intravenous oxycodone improve PACU length of stay and hemodynamic stability compared to fentanyl in geriatric patients undergoing general anesthesia for ophthalmic surgeries?
Absolute Event Rate: 32.94% vs 35.09%
Intravenous oxycodone at 0.1 mg/kg provides more stable hemodynamics during induction and comparable recovery times to fentanyl in geriatric patients undergoing ophthalmic surgeries.
0.1 mg/kg oxycodone improves hemodynamic stability versus fentanyl in geriatric ophthalmic anesthesia; extends RCT evidence for opioid selection in elderly patients.
Abstract Background: The present study aimed to compare the safety and efficacy of intravenous oxycodone with fentanyl in geriatric patients undergoing general anesthesia for ophthalmic surgeries. Methods: 107 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. Results: Patients 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. Conclusion: Oxycodone 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. Trial registration: The study was registered at http://www.chictr.org.cn , Clinical Trial Number: ChiCTR-IPR-16007927. Date of registration: February 15, 2016.
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Li et al. (2019) conducted an RCT in Ophthalmic surgeries under general anesthesia (n=105). Intravenous oxycodone vs. Fentanyl 2 mcg/kg was evaluated on PACU length of stay (minutes). Intravenous oxycodone at 0.1 mg/kg resulted in a similar PACU length of stay compared to fentanyl (32.94 vs 35.09 min), while a 0.2 mg/kg dose significantly prolonged PACU stay (42.80 min, p<0.05).
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