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CLINICAL TRIAL article

Front. Pharmacol.
Sec. Obstetric and Pediatric Pharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1515501

Oxycodone for analgesia in children undergoing endoscopic retrograde cholangiopancreatography: a randomized, double-blind, parallel study

Provisionally accepted
Ji Wei Ji Wei 1,2Liping Sun Liping Sun 1,2Yue Huang Yue Huang 1,2Jie Bai Jie Bai 1,2Jijian Zheng Jijian Zheng 1,2*Kan Zhang Kan Zhang 1,2*
  • 1 Department of Anesthesiology, Shanghai Children’s Medical Center, Shanghai, China
  • 2 School of Medicine, Shanghai Jiao Tong University, Shanghai, Shanghai Municipality, China

The final, formatted version of the article will be published soon.

    Background: Postoperative visceral pain is a common complication after endoscopic retrograde cholangiopancreatography (ERCP). In this study, we compared the analgesic and anti-inflammatory effect of oxycodone and fentanyl in children undergoing ERCP. Methods: This single center, randomized, double-blind study was conducted at a tertiary care hospital affiliated with Shanghai Jiao Tong University. Eighty-two pediatric patients aged 2 to 18 years who were scheduled for elective ERCP were randomly assigned to receive either oxycodone (0.2 mg/kg) or fentanyl (2 μg/kg). Postoperative pain was evaluated at 10 min, 20 min, 30 min in post-anesthesia care unit (PACU), 6 h and 24 h in ward after ERCP. Additionally, inflammatory cytokines in serum, including tumor necrosis factor (TNF) -α, interleukin (IL) -6 and -10 were examined by blood sampling at baseline, 6 h and 24 h after ERCP. Results: Compared to fentanyl, children receiving oxycodone had significantly lower pain scores at 30 min, 6 h and 24 h after ERCP, while scores at 10 and 20 min were similar in both groups. We also found that fewer patients had pain scores ≥ 3 at 6 h and 24 h after procedure in the oxycodone group (36.6% (15/41) vs. 61.0% (25/41) at 6 h, 34.1% (14/41) vs. 58.5% (24/41) at 24 h, both p = 0.027). Furthermore, fewer children in the oxycodone group had elevated inflammatory cytokines (IL-6 at 6 h and TNF-α at 24 h after ERCP) compared to the fentanyl group. Additionally, the incidence of postoperative vomiting was lower among children receiving oxycodone (14.1% (7/41) vs. 24.4% (10/41), p = 0.032). Conclusions: Oxycodone (0.2 mg kg-1) can provide effective analgesia and stable hemodynamics in children undergoing ERCP. This analgesic characteristic may be related to amelioration of inflammation after ERCP.

    Keywords: Oxycodone, ERCP, Visceral Pain, Children, Inflammation

    Received: 23 Oct 2024; Accepted: 13 Dec 2024.

    Copyright: © 2024 Wei, Sun, Huang, Bai, Zheng and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jijian Zheng, Department of Anesthesiology, Shanghai Children’s Medical Center, Shanghai, 200000, China
    Kan Zhang, Department of Anesthesiology, Shanghai Children’s Medical Center, Shanghai, 200000, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.