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

IF 4.8 2区 医学 Q1 PHARMACOLOGY & PHARMACY Frontiers in Pharmacology Pub Date : 2025-01-08 eCollection Date: 2024-01-01 DOI:10.3389/fphar.2024.1515501
Wei Ji, Liping Sun, Yue Huang, Jie Bai, Jijian Zheng, Kan Zhang
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Abstract

Background: Postoperative visceral pain is a common complication after endoscopic retrograde cholangiopancreatography (ERCP). In this study, we compared the analgesic and anti-inflammatory effects of oxycodone and fentanyl in children undergoing ERCP.

Methods: A single-center, randomized, double-blind study was conducted at a tertiary care hospital affiliated with Shanghai Jiao Tong University. Eighty-two pediatric patients aged 2-18 years who were scheduled for elective ERCP were randomly assigned to receive either oxycodone (0.2 mg/kg) or fentanyl (2 μg/kg). The postoperative pain was evaluated after 10 min, 20 min, and 30 min in the post-anesthesia care unit (PACU) as well as 6 h and 24 h in the ward following ERCP. Additionally, inflammatory cytokines in the serum, including tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-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 the 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 the 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, p = 0.027 for both cases]. 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. The incidence of postoperative vomiting was also lower among children receiving oxycodone [14.1% (7/41) vs. 24.4% (10/41), p = 0.032].

Conclusion: 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.

Clinical trial registration: www.chictr.org.cn, identifier ChiCTR2300074473.

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羟考酮用于内镜逆行胆管造影儿童的镇痛:一项随机、双盲、平行研究。
背景:术后内脏疼痛是内镜逆行胆管造影(ERCP)后常见的并发症。在这项研究中,我们比较了羟考酮和芬太尼在接受ERCP的儿童中的镇痛和抗炎作用。方法:在上海交通大学附属某三级医院进行单中心、随机、双盲研究。82例2-18岁的儿童患者计划进行选择性ERCP,随机分配接受羟考酮(0.2 mg/kg)或芬太尼(2 μg/kg)。术后疼痛在麻醉后护理病房(PACU)分别于10分钟、20分钟和30分钟,以及在ERCP后的病房内分别于6小时和24小时进行评估。此外,在ERCP后基线、6小时和24小时,通过采血检测血清中的炎症因子,包括肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6和IL-10。结果:与芬太尼相比,羟考酮在ERCP后30分钟、6小时和24小时的疼痛评分明显低于芬太尼,而两组在ERCP后10分钟和20分钟的评分相似。我们还发现,羟考酮组在术后6小时和24小时疼痛评分≥3的患者较少[6小时时36.6%(15/41)比61.0%(25/41),24小时时34.1%(14/41)比58.5%(24/41),两例p = 0.027]。此外,与芬太尼组相比,羟考酮组炎症因子(ERCP后6小时IL-6和24小时TNF-α)升高的儿童较少。接受羟考酮治疗的患儿术后呕吐发生率也较低[14.1%(7/41)比24.4% (10/41),p = 0.032]。结论:羟考酮(0.2 mg kg-1)对ERCP患儿具有良好的镇痛效果和稳定的血流动力学。这种镇痛特性可能与ERCP后炎症的改善有关。临床试验注册:www.chictr.org.cn,标识符ChiCTR2300074473。
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来源期刊
Frontiers in Pharmacology
Frontiers in Pharmacology PHARMACOLOGY & PHARMACY-
CiteScore
7.80
自引率
8.90%
发文量
5163
审稿时长
14 weeks
期刊介绍: Frontiers in Pharmacology is a leading journal in its field, publishing rigorously peer-reviewed research across disciplines, including basic and clinical pharmacology, medicinal chemistry, pharmacy and toxicology. Field Chief Editor Heike Wulff at UC Davis is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
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