Application of oxycodone in multimodal analgesia for thoracoscopic lung surgery: A single-center retrospective...

In video-assisted thoracoscopic surgery, sufentanil patient-controlled intravenous analgesia (PCIA) demands continuous infusion, raising opioid load and side-effects while lacking κ-receptor visceral coverage. Oxycodone's dual µ/κ profile and longer action allow demand-only PCIA. We compared the 2 within a standardized TPVB-NSAID protocol. Single-center retrospective study (Jan 2017-Dec 2018). Adults undergoing video-assisted thoracoscopic lung surgery with multimodal analgesia were allocated to sufentanil (S) or oxycodone (O) PCIA. After 1:1 propensity matching (n = 527 per group), opioid consumption, numerical rating scale pain, analgesic demands, PONV, dizziness, sleep quality and length of stay were compared. Matched groups were comparable demographically and intraoperatively. Postoperative days 1 to 2 opioid use (morphine equivalents) was lower in O (0.8 mg and 1.2 mg) than S (27.4 mg and 36.5 mg; P < .001). Resting numerical rating scale on day 2 favored O (P = .043); exercise scores were similar. Patients pressed the O pump more often (2 vs 0 and 3 vs 1; P <.01). PONV day-1: O 1.5 %, S 6.5 % (P <.001); dizziness: 3.8 % vs 9.9 % (P <.001). Good sleep reported in 73.1 % O vs 61.9 % S (P <.001). Postoperative stay shorter in O (P = .002). Within a TPVB-NSAID multimodal regimen, oxycodone-based PCIA provided equivalent analgesia, lower opioid consumption and fewer adverse effects than sufentanil-based PCIA, and was associated with earlier discharge after thoracoscopic lung surgery.