Wang Xinyi, Narayan Sujita W, Penm Jonathan, Johnstone Charlotte, Patanwala Asad E
The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, New South Wales, Australia.
Department of Anaesthesia, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Pain Physician. 2021 May;24(3):E309-E315.
Tapentadol has relatively less effect on mu-opioid receptors compared with other opioids. This has the potential to reduce the occurrence of gastrointestinal (GI) adverse drug events (ADEs).
To compare the GI ADEs during hospitalization between tapentadol immediate release (IR) and oxycodone IR following orthopedic surgeries.
Retrospective cohort study.
A major metropolitan tertiary referral hospital in Australia.
Data for adult orthopedic surgery patients receiving postoperative tapentadol IR or oxycodone IR during hospitalization between January 1, 2018 and June 30, 2019, were collected from electronic medical records. The primary outcome was the occurrence of postoperative GI ADEs occurring during hospitalization. This was defined as a composite of nausea, vomiting, or constipation.
The study cohort included 199 patients. Of these, 99 patients received tapentadol IR and 100 patients received oxycodone IR for postoperative pain during hospitalization. The mean age was 66 ± 12 years, and 111 patients (56%) were women. There was no significant difference between groups on the occurrence of GI ADEs (53% in oxycodone group and 51% in tapentadol group, difference 2%, 95% confidence interval [CI], -11% to 16%; P = 0.777). After adjusting for potential confounders, the use of tapentadol IR was not associated with a significant reduction of GI ADEs (odds ratio, 0.62; 95% CI, 0.32-1.20; P = 0.154).
This was a single-center study and should be extrapolated with caution. As this was a retrospective study, the accuracy and availability of data were dependent on documentation in electronic medical records.
Tapentadol IR is associated with similar GI ADE occurrence compared with oxycodone IR in patients with orthopedic postoperative pain during hospitalization.
与其他阿片类药物相比，曲马多对μ-阿片受体的作用相对较小。这有可能减少胃肠道（GI）不良药物事件（ADEs）的发生。
比较骨科手术后住院期间即释曲马多（IR）和即释羟考酮的胃肠道ADEs。
回顾性队列研究。
澳大利亚一家主要的大都市三级转诊医院。
收集2018年1月1日至2019年6月30日住院期间接受术后即释曲马多或即释羟考酮的成年骨科手术患者的数据，这些数据来自电子病历。主要结局是住院期间发生的术后胃肠道ADEs。这被定义为恶心、呕吐或便秘的综合情况。
研究队列包括199名患者。其中，99名患者在住院期间接受即释曲马多用于术后疼痛，100名患者接受即释羟考酮。平均年龄为66±12岁，111名患者（56%）为女性。两组在胃肠道ADEs的发生率上无显著差异（羟考酮组为53%，曲马多组为51%，差异为2%，95%置信区间[CI]，-11%至16%；P = 0.777）。在对潜在混杂因素进行调整后，即释曲马多的使用与胃肠道ADEs的显著减少无关（比值比，0.62；95%CI，0.32 - 1.20；P = 0.154）。
这是一项单中心研究，外推时应谨慎。由于这是一项回顾性研究，数据的准确性和可获得性取决于电子病历中的记录。
在住院期间有骨科术后疼痛的患者中，即释曲马多与即释羟考酮的胃肠道ADEs发生率相似。
