AUTHOR=Lao Wei-long , Song Qi-liang , Jiang Zong-ming , Chen Wen-di , Zheng Xian-he , Chen Zhong-hua 

TITLE=The Effect of Oxycodone on Post-operative Pain and Inflammatory Cytokine Release in Elderly Patients Undergoing Laparoscopic Gastrectomy

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.700025

DOI=10.3389/fmed.2021.700025

ISSN=2296-858X

ABSTRACT=<p><bold>Background:</bold> To evaluate the effect of oxycodone on post-operative pain and inflammation in elderly patients undergoing laparoscopic gastrectomy.</p><p><bold>Methods:</bold> Sixty patients who were of both sexes, American Society of Anesthesiologists Physical Status (ASA-PS) Class I or II, over 65 years of age and undergoing an elective laparoscopic radical gastrectomy were randomly divided into two groups: an oxycodone group (Group O) including 20 males and 10 females and a sufentanil group (Group S) including 21 males and 9 females. The post-operative analgesia regimen was as follows: 40 mg of parecoxib sodium and 0.1 mg/kg of oxycodone was intravenously injected into Group O before the abdomen closure, while 40 mg of parecoxib sodium and 0.1 μg/kg of sufentanil was injected intravenously into Group S. Both groups were infiltrated with 20 ml of 1% ropivacaine at the end of the operation. The level of serum IL-6 and IL-10 were assayed immediately at the following timepoints: at the conclusion of surgery (T1), 1 h (T2), 6 h (T3), and 24 h (T4) after the completion of the surgery. The numerical rating scale (NRS), the Ramsay sedation score, analgesic-related adverse events, post-operative pulmonary inflammation events and the post-operative stay were recorded.</p><p><bold>Results:</bold> Compared with Group S, the serum IL-6 concentrations of Group O decreased at T<sub>3</sub> and T<sub>4</sub>, while the serum IL-10 concentrations increased (<italic>P</italic> &lt; 0.05). In Group O, the serum IL-6 concentrations at T<sub>3</sub> and T<sub>4</sub> were lower than those at T<sub>1</sub> (<italic>P</italic> &lt; 0.05). The incidence of post-operative nausea and vomiting (PONV) and pulmonary inflammation in Group O was lower than that in Group S (<italic>P</italic> &lt; 0.05). At each time point, the NRS of visceral pain in Group O was lower than that in Group S. At 6 and 24 h after extubation, the NRS of incision pain in Group O was lower than that in Group S (<italic>P</italic> &lt; 0.05).</p><p><bold>Conclusion:</bold> Oxycodone can regulate the level of inflammatory cytokines and reduce post-operative inflammatory response.</p>