Comparison of the analgesic effects of intrabursal oxycodone and bupivacaine after acromioplasty

Study Objectives: To compare the peripheral analgesic effect of oxycodone, an opioid agonist, to the effect of bupivacaine infiltration and parenteral oxycodone administration in conjunction with shoulder surgery. Design: Prospective, randomized, double-blind study. Setting: University teaching hospital. Patients: 42 ASA physical status I and II patients scheduled for shoulder s urgery with general anesthesia. Interventions: Patients were randomized to three study groups: at the end o f the surgery patients received wither 10 ml of 0.5% bupivacaine (group BIB ) or 5 mg of oxycodone in 10 ml of saline (group OIB) in the subacromial bu rsa; or 5 mg of oxycodone intramuscularly (group OIM). Postoperative analge sia was provided by patient-controlled analgesia (PCA). Measurements and Main Results: The fentanyl requirements were recorded for the 24-hour postoperative period and the total perioperative period. Postop erative pain was assessed by visual analog scale for pain (VASP). Plasma ox ycodone concentrations were measured in groups OIB and OIM. The total perio perative fentanyl consumption was significantly lower in groups BIB (0.97 /- 0.09 mg) and OIB (1.23 +/- 0.12 mg) than in group OIM (1.61 +/- 0.12 mg) (p = 0.01 and 0.048, respectively). Groups BIB and OIB were similar (p = 0 .34). The absorption of oxycodone was significantly lower after subacromial than after intramuscular administration. Conclusion: Intrabursal oxycodone and intrabursal bupivacaine reduced perio perative analgesic requirements similarly. Intrabursal oxycodone may offer an effective, simple, and safe method for postoperative analgesia after sho ulder surgery. (C) 1999 by Elsevier Science Inc.