Adverse effects of commonly ordered oral narcotics

Area of Science:

• Pharmacology
• Clinical Pain Management

Background:

• Post-surgical pain management often involves multiple analgesic options.
• Comparing the efficacy and safety profiles of different analgesics is crucial for optimizing patient care.

Purpose of the Study:

• To compare the adverse effects of approximately equianalgesic oral doses of codeine, an oxycodone compound, and pentazocine.
• To evaluate the efficacy and safety of these analgesics against placebo and parenteral morphine in postsurgical pain.

Main Methods:

• A double-blind, randomized study involving 247 postsurgical patients with pain.
• Four doses of each drug (codeine, oxycodone compound, pentazocine, placebo, parenteral morphine) were administered over two days, with approximately 50 patients per group.
• Adverse effects and analgesic performance were recorded.

Main Results:

• Codeine, pentazocine, and morphine demonstrated similar incidence rates of adverse effects (22-28%).
• The oxycodone compound was found to be analgesic equivalent to 12.5 mg morphine but had a significantly lower adverse effect incidence (4%) compared to placebo (8%).
• Smoking did not influence analgesic effect or adverse effects.

Conclusions:

• The oxycodone compound offers a favorable safety profile for managing postsurgical pain compared to codeine, pentazocine, and morphine.
• Further investigation may be warranted regarding the potential influence of evening analgesics on subsequent placebo performance.