Morphine versus oxycodone analgesia after percutaneous kidney stone surgery: a randomised double blinded study

Area of Science:

• Anesthesiology
• Pharmacology
• Nephrology

Background:

• Previous research suggested oxycodone may offer benefits over morphine for visceral pain management.
• Percutaneous nephrolithotomy (PCNL) involves significant postoperative pain, necessitating effective analgesia.
• Minimizing the somatic pain component in PCNL allows for focused investigation of visceral pain management.

Purpose of the Study:

• To compare opioid consumption, pain relief, and side effects between morphine and oxycodone post-PCNL.
• To evaluate the efficacy of oxycodone versus morphine in managing visceral pain after kidney stone surgery.
• To test the hypothesis that oxycodone is superior to morphine for visceral pain after PCNL.

Main Methods:

• A randomized controlled trial involving 44 adult patients undergoing PCNL.
• Intravenous administration of either morphine or oxycodone for postoperative pain management.
• Systematic registration of opioid consumption, pain scores, and side effects (nausea, dizziness, sedation, respiratory effects, itching) during the first 4 hours post-surgery.

Main Results:

• Mean opioid consumption was comparable between the morphine (18.93 mg) and oxycodone (16.15 mg) groups (P = 0.7).
• Both morphine and oxycodone demonstrated similar analgesic effects in the initial 4 hours post-surgery.
• Nausea was reported significantly less frequently in the morphine group compared to the oxycodone group (P = 0.03).

Conclusions:

• The study did not confirm the hypothesis that oxycodone is superior to morphine for visceral pain after percutaneous kidney stone operations.
• Morphine and oxycodone provided comparable analgesia in the early postoperative period following PCNL.
• Morphine was associated with a lower incidence of nausea, a key side effect, compared to oxycodone in this patient cohort.