Comparison of oxycodone with morphine as adjuvant epidural analgesia and its side effects: A systematic review

Despite morphine’s ability to deliver effective analgesia, its use as an epidural adjuvant is limited by adverse effects such as nausea, vomiting, and pruritus, which are typically intractable with conventional antihistamines. Another negative effect that we are particularly concerned about is respi...

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Main Authors: Tjokorda Gde Agung Senapathi, Dewa Ngakan Gde Dwija Sanjaya, Adinda Putra Pradhana, Christopher Ryalino, Ida Bagus Krisna Jaya Sutawan
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-01-01
Series:Bali Journal of Anesthesiology
Subjects:
Online Access:http://www.bjoaonline.com/article.asp?issn=2549-2276;year=2022;volume=6;issue=3;spage=127;epage=132;aulast=Senapathi
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author Tjokorda Gde Agung Senapathi
Dewa Ngakan Gde Dwija Sanjaya
Adinda Putra Pradhana
Christopher Ryalino
Ida Bagus Krisna Jaya Sutawan
author_facet Tjokorda Gde Agung Senapathi
Dewa Ngakan Gde Dwija Sanjaya
Adinda Putra Pradhana
Christopher Ryalino
Ida Bagus Krisna Jaya Sutawan
author_sort Tjokorda Gde Agung Senapathi
collection DOAJ
description Despite morphine’s ability to deliver effective analgesia, its use as an epidural adjuvant is limited by adverse effects such as nausea, vomiting, and pruritus, which are typically intractable with conventional antihistamines. Another negative effect that we are particularly concerned about is respiratory depression. This systematic review aimed to summarize the evidence based on randomized controlled trials (RCTs) comparing epidural analgesic adjuvants between oxycodone and morphine. We searched the Cochrane Library, PubMed, and EMBASE databases from 1990 until 2021 to find RCTs published in English language, which have investigated pain score and side effects such nausea and vomiting. Three RCTs were included in the final analysis. All of them employed similar argument that epidural analgesic with oxycodone has good analgesic effects at higher dose than morphine. Oxycodone provides analgesic properties equivalent to morphine, but with less nausea and vomiting. We found that epidural analgesic with oxycodone has comparable analgesic effect to morphine, as well as lower side effects on nausea and vomiting at twice morphine doses. Future study is needed to compare epidural oxycodone with morphine in terms of analgesia and adverse effects.
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spelling doaj.art-f275dad1a9034a159ea92e45c4ac9d9e2022-12-22T01:33:02ZengWolters Kluwer Medknow PublicationsBali Journal of Anesthesiology2549-22762022-01-016312713210.4103/bjoa.bjoa_83_22Comparison of oxycodone with morphine as adjuvant epidural analgesia and its side effects: A systematic reviewTjokorda Gde Agung SenapathiDewa Ngakan Gde Dwija SanjayaAdinda Putra PradhanaChristopher RyalinoIda Bagus Krisna Jaya SutawanDespite morphine’s ability to deliver effective analgesia, its use as an epidural adjuvant is limited by adverse effects such as nausea, vomiting, and pruritus, which are typically intractable with conventional antihistamines. Another negative effect that we are particularly concerned about is respiratory depression. This systematic review aimed to summarize the evidence based on randomized controlled trials (RCTs) comparing epidural analgesic adjuvants between oxycodone and morphine. We searched the Cochrane Library, PubMed, and EMBASE databases from 1990 until 2021 to find RCTs published in English language, which have investigated pain score and side effects such nausea and vomiting. Three RCTs were included in the final analysis. All of them employed similar argument that epidural analgesic with oxycodone has good analgesic effects at higher dose than morphine. Oxycodone provides analgesic properties equivalent to morphine, but with less nausea and vomiting. We found that epidural analgesic with oxycodone has comparable analgesic effect to morphine, as well as lower side effects on nausea and vomiting at twice morphine doses. Future study is needed to compare epidural oxycodone with morphine in terms of analgesia and adverse effects.http://www.bjoaonline.com/article.asp?issn=2549-2276;year=2022;volume=6;issue=3;spage=127;epage=132;aulast=Senapathimorphinenauseaoxycodonepainpruritus
spellingShingle Tjokorda Gde Agung Senapathi
Dewa Ngakan Gde Dwija Sanjaya
Adinda Putra Pradhana
Christopher Ryalino
Ida Bagus Krisna Jaya Sutawan
Comparison of oxycodone with morphine as adjuvant epidural analgesia and its side effects: A systematic review
Bali Journal of Anesthesiology
morphine
nausea
oxycodone
pain
pruritus
title Comparison of oxycodone with morphine as adjuvant epidural analgesia and its side effects: A systematic review
title_full Comparison of oxycodone with morphine as adjuvant epidural analgesia and its side effects: A systematic review
title_fullStr Comparison of oxycodone with morphine as adjuvant epidural analgesia and its side effects: A systematic review
title_full_unstemmed Comparison of oxycodone with morphine as adjuvant epidural analgesia and its side effects: A systematic review
title_short Comparison of oxycodone with morphine as adjuvant epidural analgesia and its side effects: A systematic review
title_sort comparison of oxycodone with morphine as adjuvant epidural analgesia and its side effects a systematic review
topic morphine
nausea
oxycodone
pain
pruritus
url http://www.bjoaonline.com/article.asp?issn=2549-2276;year=2022;volume=6;issue=3;spage=127;epage=132;aulast=Senapathi
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