Oxycodone associated with less cognitive impact than sufentanil for older people

Postoperative cognitive dysfunction (POCD) is common after orthopedic surgery, and has a potentially serious adverse impact upon clinical outcomes for older people undergoing surgery. Researchers from China have recently compared impacts of different approaches to patient-controlled intravenous analgesia (PCIA) upon cognition after arthroplastic surgery. 99 subjects were allocated to receive PCIA using either oxycodone group or sufentanil . The primary outcome was the incidence of POCD, assessed using the Mini-mental status examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. Secondary outcomes included the amount of postoperative analgesic used and the incidence of adverse reactions. POCD was significantly lower in patients receiving oxycodone up to the 3rd postoperative day, compared to patients receiving sufentanil, but cognition was adversely impacted by both drugs to some extent. The number of PCIA boluses and consumption of analgesia were similar with both drugs, but postoperative nausea, vomiting and pruritus were less prevalent for those receiving oxycodone. Perhaps the much maligned oxycodone option is less harmful for older people than the newer drug sufentanil? Read more detail here.