Patient-controlled analgesia with oxycodone in the treatment of postcraniotomy pain

Background: Moderate to severe pain occurs after craniotomy in 60% of patie nts. We evaluated the feasibility and safety of patient-controlled analgesi a (PCA) with oxycodone in neurosurgical patients, and compared the efficacy of paracetamol with ketoprofen. Methods: Ln the study there were 45 patients, who received either paracetam ol 1000 mg or ketoprofen 100 mg three times a day Oxycodone-boluses 0.03 mg /kg were given by PCA-device maximally three times an hour, lock-out time 1 0 min. The amount of oxycodone used, pain scores and side-effects were reco rded. Results: The ketoprofen group required less oxycodone than the paracetamol group (medians 37.1 mg vs 19.6 mg, P < 0.05). The VAS scores were comparabl e between the groups at the beginning of the study, curing the first postop erative evening and the next morning, but the paracetamol group had a highe r score at the conclusion of the study (P < 0.05). The patients in both gro ups were equally satisfied with the pain relief. There were no differences in side-effects between the groups. Conclusions: PCA with oxycodone is a suitable method for pain control after craniotomy. No progressive hypoventilation, desaturation or excessive seda tion were encountered. Ketoprofen appeared to be more effective than parace tamol.