Oxycodone/naloxone in postoperative pain management of surgical patients

Ioannis D. Gkegkes, MD, PhD; Evelyn Eleni Minis, MD; Christos Iavazzo, MD, MSc, PhD

doi:10.5055/jom.2018.0429

Authors

Ioannis D. Gkegkes, MD, PhD
Evelyn Eleni Minis, MD
Christos Iavazzo, MD, MSc, PhD

DOI:

https://doi.org/10.5055/jom.2018.0429

Keywords:

postoperative analgesia, analgesics, postoperative pain, opioid-induced constipation, opioids, oxycodone, naloxone

Abstract

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.

Author Biographies

Ioannis D. Gkegkes, MD, PhD

First Department of Surgery, General Hospital of Attica “KAT,” Athens, Greece

Evelyn Eleni Minis, MD

First Department of Surgery, General Hospital of Attica “KAT,” Athens, Greece

Christos Iavazzo, MD, MSc, PhD

Gynecological Oncology Department, Northampton General Hospital, Northampton, United Kingdom

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