Oxycodone Combined with Dexmedetomidine versus Oxycodone Alone and Sufentanil for Early Postoperative Analgesia and Perioperative Outcomes After Laparoscopic Surgery: A Randomized Controlled Trial

Abstract

Objective To compare the early postoperative analgesic efficacy, perioperative outcomes and safety of oxycodone combined with dexmedetomidine, oxycodone alone and sufentanil alone in patients undergoing laparoscopic surgery, so as to provide evidence-based reference for optimizing clinical analgesic strategies. Methods A total of 302 patients scheduled for elective laparoscopic surgery were prospectively enrolled and randomly divided into three groups: Group A (oxycodone combined with dexmedetomidine, n=104), Group B (oxycodone monotherapy, n=99), and Group C (sufentanil alone, n=99). The resting Visual Analogue Scale (VAS) pain score, mean arterial pressure (MAP), and Ramsay sedation score were recorded at different postoperative time points. The consumption of analgesic pump drugs, pressing times and adverse reactions were documented. The primary endpoint was the resting VAS score at 12 hours after surgery. Results From 2 to 12 hours postoperatively, the VAS scores in Group A were significantly lower than those in Group B and Group C (P<0.01), and Group B had lower VAS scores than Group C (P<0.05). There was no significant difference in VAS scores among the three groups at 24 and 48 hours after surgery. In the early postoperative period, the mean arterial pressure in Group A was markedly lower than that in Group B and Group C (P<0.05), and the difference disappeared 24 hours after operation. The cumulative consumption of analgesic pump and effective pressing times in Group A and Group B were significantly lower than those in Group C (P<0.001), and Group A was superior to Group B (P<0.05). No statistical difference was observed in the incidence of adverse reactions among the three groups (P>0.05). Conclusion Oxycodone combined with dexmedetomidine can improve early postoperative analgesia, reduce opioid consumption with satisfactory safety. The clinical benefit is mainly limited to the early postoperative stage, which is consistent with the concept of enhanced recovery after surgery.