Comparison of Analgesic and Adverse Effects of Oxycodone- and Fentanyl-Based Patient-Controlled Analgesia in Patients Undergoing Robot-Assisted Laparoscopic Gastrectomy Using a 55:1 Potency Ratio of Oxycodone to Fentanyl: A Retrospective Study

Figures & data

Figure 1 Consort diagram of patients.

Abbreviation: IV-PCA, intravenous patient-controlled analgesia.

Table 1 Demographics and Intraoperative Parameters

	Oxycodone Group (n = 49)	Fentanyl Group (n = 51)	P value
Age, years	53 ± 10	55 ± 11	0.273
BMI	23.6 ± 2.6	23.0 ± 2.9	0.270
Male sex	30 (61%)	17 (33%)	0.005*
ASA physical status, I/II/III	24/22/3	22/26/3	0.897
Comorbidities
Hypertension	11 (23%)	21 (41%)	0.045*
Diabetes mellitus	8 (16%)	6 (12%)	0.511
Hepatitis	0 (0%)	1 (2%)	>0.999
Heart disease	2 (4%)	1 (2%)	0.614
Subtotal/Total	35/14	42/9	0.194
Anesthesia time, min	235.0 ± 61.0	224.4 ± 61.6	0.391
Pneumoperitoneum time, min	142.9 ± 53.7	132.9 ± 61.6	0.391
Total remifentanil amounts, µg	769.4 ± 276.3	719.6 ± 282.1	0.375
Fluid intake, mL	1332 ± 400	1331 ± 584	0.998
Blood loss, mL	42 ± 38	59 ± 94	0.237
Urine output, mL	176 ± 104	208 ± 122	0.173
Hospital days	5.5 ± 1.5	5.7 ± 3.0	0.744

Notes: Data are presented as mean ± standard deviation or number of patients (proportion). *P <0.05.

Abbreviations: BMI, body mass index; ASA, American Society of Anesthesiologist; Subtotal, subtotal gastrectomy; Total, total gastrectomy.

Figure 2 Changes in resting (A) and active (B) pain intensity until 48 hours after surgery.

Abbreviation: NRS, numeric rating score.

Figure 3 Number of cumulative bolus deliveries (A), cumulative bolus attempts (B), and ratio of deliveries to attempts (C). *Bonferroni-corrected P < 0.05 compared with the fentanyl group.

Table 2 Number of Patients Who Required Additional Rescue Analgesics and Expressed PONV During 48 Hours After Surgery

	Oxycodone Group (n = 49)	Fentanyl Group (n = 51)	P value
Additional rescue analgesics
PACU	6 (12%)	19 (37%)	0.005*
1–6 h	30 (61%)	36 (71%)	0.400
6–12 h	29 (59%)	25 (49%)	0.324
12–24 h	34 (69%)	28 (55%)	0.154
24–48 h	23 (47%)	26 (51%)	0.659
Nausea
PACU	1 (2%)	8 (16%)	0.031*
1–6 h	7 (14%)	13 (26%)	0.213
6–12 h	14 (29%)	15 (29%)	>0.999
12–24 h	12 (25%)	10 (20%)	0.633
24–48 h	2 (4%)	4 (8%)	0.678
Vomiting
PACU	–	–
1–6 h	1 (2%)	3 (6%)	0.618
6–12 h	2 (4%)	6 (12%)	0.269
12–24 h	–	1 (2%)	>0.999
24–48 h	–	–

Notes: Data are presented as number of patients (proportion). *P <0.05.

Abbreviation: PONV, postoperative nausea and vomiting.

Table 3 Multivariate Regression Analysis of the Number of Patients Requiring Additional Rescue Analgesics and Who Expressed Postoperative Nausea in the PACU

	Additional Rescue Analgesics		Nausea
	OR (95% CI)	P value	OR (95% CI)	P value
Group
Oxycodone	1		1
Fentanyl	4.68(1.53–14.37)	0.007*	6.38 (0.73–55.70)	0.094
Sex
Male	1		1
Female	1.08 (0.37–3.14)	0.891	2.91 (0.48–17.44)	0.244
History of HTN
No	1		1
Yes	0.56 (0.18–1.74)	0.318	1.88 (0.40–8.83)	0.425

Note: *P <0.05.

Abbreviations: OR, odds ratio; CI, confidence interval; HTN, hypertension; PACU, post-anesthetic care unit.

Table 4 Other Adverse Effects During 48 Hours After Surgery

	Oxycodone Group (n = 49)	Fentanyl Group (n = 51)	P value
Dizziness	16 (33%)	13 (26%)	0.511
Headache	2 (4%)	0 (0%)	0.238
Retching	–	1 (2%)	>0.999
Numbness	–	1 (2%)	>0.999
Chills	–	1 (2%)	>0.999
Level of sedation at PACU, 0/1/2/3/4	0/7/42/0/0	0/4/47/0/0	0.303

Notes: Data are presented as median (interquartile range) or number of patients (proportion). Level of sedation; 0 = fully awake, 1= drowsy/closed eyes, 2 = asleep/easily aroused with light tactile stimulation or a simple verbal command, 3 = asleep/aroused only by strong physical stimulation, and 4 = unarousable.

Figure 4 Mean blood pressure (A) and heart rate during 48 h after surgery (B).

Abbreviation: PACU, post-anesthesia care unit.