Document Detail


Use of oxycodone in polytrauma patients: the "Gemelli" experience.
MedLine Citation:
PMID:  18575163     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: This is the first study investigating the effect of oxycodone in polytrauma patients. The management of pain in polytrauma patients has become a very relevant issue. Nonsteroidal anti-inflammatory drugs (NSAIDs) represent the most used drugs in polytrauma patients, even though their use is associated with an increased hemorrhagic risk. Previous studies have demonstrated the efficacy of oxycodone for the treatment of acute pain. The aim of this study was to assess the efficacy of oxycodone administration in polytrauma patients, with minor injuries. PATIENTS AND METHODS: 15 polytrauma patients (10 males, mean age 40 +/- 13 years; 5 females, mean age 49 +/- 26 years) were admitted to the Emergency Department of the Catholic University, A. Gemelli Hospital in Rome, Italy. All patients underwent physical examination, FAST ultrasound, total body CT scanning and blood tests. Three patients had multiple costal fractures, three had pelvic fracture, two had tibial fracture, five had vertebral fractures, one patient had clavicle fracture and ulnar fracture, one patient a severe trauma of the left leg, which required amputation. Five patients also reported minor head trauma, with a Glasgow Coma Score (GCS) 15. All patients reported abdominal trauma, while none of them had severe thoracic or kidney damage. Patients with head trauma also underwent a second CT head scanning 12 hours after admission, which excluded the occurrence of cerebral damage. All patients were then treated with oral administration of oxycodone 10 mg two times per day (bid) for 3 days. Pain intensity, before and after the administration of oxycodone, was evaluated using a scale ranging from 0 to 10. RESULTS: The mean pain score at admission was 8 +/- 0.7. All patients reported significant pain improvement after the administration of oxycodone (8 +/- 0.7 vs 1.8 +/- 0.9; p < 0.0001). A dosage increase of oxycodone from 20 to 40 mg bid was required in only one patient with a clavicle fracture. The main side effects were light-headache (5 patients), constipation (4 patients) and nausea (3 patients). CONCLUSIONS: These data indicate that oxycodone is a safe and effective drug for pain relief in polytrauma patients without severe thoracic, kidney or brain damage.
Authors:
F Franceschi; M Marini; S Ursella; L Carbone; M Candelli; G Pignataro; M Gabrielli; L Santarelli; V Ojetti; B Giupponi; V Fiore; F Barbaro; G De Marco; F Buccelletti; F Mancini; D Roccarina; G Gigante; A Gasbarrini; G Gasbarrini; N Gentiloni Silveri
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  European review for medical and pharmacological sciences     Volume:  12     ISSN:  1128-3602     ISO Abbreviation:  Eur Rev Med Pharmacol Sci     Publication Date:    2008 Mar-Apr
Date Detail:
Created Date:  2008-06-25     Completed Date:  2008-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9717360     Medline TA:  Eur Rev Med Pharmacol Sci     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  123-6     Citation Subset:  IM    
Affiliation:
Emergency Department, Catholic University of Rome, Italy. francesco.franceschi@rm.unicatt.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analgesics, Opioid / administration & dosage,  adverse effects,  therapeutic use*
Constipation / chemically induced
Dose-Response Relationship, Drug
Emergency Service, Hospital
Female
Headache / chemically induced
Humans
Male
Middle Aged
Multiple Trauma / complications*
Nausea / chemically induced
Oxycodone / administration & dosage,  adverse effects,  therapeutic use*
Pain / drug therapy*,  etiology
Pain Measurement
Pilot Projects
Prospective Studies
Rome
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 76-42-6/Oxycodone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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