Pain management in peripheral arterial obstructive disease: oral slow-release oxycodone versus epidural l-bupivacaine

Eur J Vasc Endovasc Surg. 2010 Jun;39(6):774-8. doi: 10.1016/j.ejvs.2010.02.016. Epub 2010 Mar 23.

Abstract

Objectives: To compare the effectiveness of oral slow-release oxycodone (group OX, n=18) with that of epidural l-bupivacaine (group LRA, n=13) for the control of moderate/severe pain of advanced-stage peripheral arterial obstructive disease (PAOD) patients.

Design: Observational and retrospective analysis of advanced stage and hospitalised PAOD patients treated for pain management for at least 7 days prior to surgery or discharged from the hospital without surgery.

Methods: The outcome measures were pain intensity using the visual analogue scale under static, (VASs) and dynamic (VASd) conditions; vital signs, treatment side effects and patient satisfaction.

Results: In both groups, pain control was satisfactory and VAS scores median were VASs<3 and VASd<4; under dynamic conditions, pain control was better in the LRA group (p<0.01). Against few and transient side effects, most patients (n=30) found both pain treatments good or excellent. Results should be confirmed by studies with larger samples.

Conclusions: In the perioperative setting, the epidural infusion of local anaesthetics, such as l-bupivacaine, is an effective technique for pain control in PAOD patients; for patients with contraindication for this technique or for non-surgical or outpatients, slow-release oxycodone is suggested as a possible alternative for the control of severe pain in these patients.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Oral
  • Aged
  • Analgesics, Opioid / administration & dosage*
  • Anesthetics, Local / administration & dosage*
  • Arterial Occlusive Diseases / complications*
  • Arterial Occlusive Diseases / drug therapy
  • Bupivacaine / administration & dosage*
  • Delayed-Action Preparations / administration & dosage
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Humans
  • Injections, Epidural
  • Male
  • Oxycodone / administration & dosage*
  • Pain / diagnosis
  • Pain / etiology
  • Pain Management*
  • Pain Measurement
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Analgesics, Opioid
  • Anesthetics, Local
  • Delayed-Action Preparations
  • Oxycodone
  • Bupivacaine