Oxycodone

Comparative studies

The postoperative analgesic effects of intravenous ketamine 10 mg and oxycodone 2 mg have been compared in a randomized, double-blind study in 40 tonsillectomized men [ ]. There were no significant differences between the two analgesics. The patients found ketamine more acceptable than oxycodone. Oxycodone was associated with more skin problems, especially pruritus. Oxycodone also caused a significantly lower respiratory rate with lower oxygen saturation throughout the recovery period and increased sedation throughout the study.

Oxycodone has been compared with fentanyl in the management of postoperative pain after laparoscopic cholecystectomy in patients who were randomized to oxycodone 5 or 10 mg (n = 39) or fentanyl 50–100 micrograms (n = 39), depending on pain severity [ ]. Oxycodone produced better analgesia but more adverse reactions, including moderate or severe nausea, vomiting, and sedation. The authors suggested that the doses of fentanyl and oxycodone were not equipotent.

Placebo-controlled studies

The effects of modified-release oxycodone in osteoarthritic pain have been evaluated in a placebo-controlled, double-blind trial in 133 patients [ ]. Oxycodone was effective, and although opioid-related adverse reactions were frequent they were considered acceptable by the authors.

In a randomized, double-blind, crossover study, previous findings on adverse reactions to oxycodone among sufferers of postherpetic neuralgia were confirmed [ ]. Oxycodone was effective, but 76% of the sample reported adverse reactions compared with 49% of the placebo group. Constipation, nausea, and sedation were the most frequently reported adverse reactions.

Psychological

There was only marginal impairment in working memory in 18 healthy individuals after the administration of oxycodone 5 mg [ ]. This subtle impairment was found in the nine women who took part.

Liver

Cholestatic hepatitis occurred in a 34-year-old man who took oxycodone 40 mg in the morning and 20 mg at night for analgesia after T11 vertebrectomy [ ]. He developed jaundice and severe pruritus, which resolved on withdrawal of oxycodone. All other causes of hepatotoxicity were eliminated.