A randomized, double-blind, placebo-controlled study of preemptive oral oxycodone with morphine patient-controlled anesthesia for postoperative pain management in patients undergoing uterine artery embolization for symptomatic uterine fibroids

Cardiovasc Intervent Radiol. 2014 Oct;37(5):1191-7. doi: 10.1007/s00270-014-0913-2. Epub 2014 Jul 1.


Purpose: To evaluate the analgesic efficacy of oral premedication of oxycodone in a group of patients undergoing elective uterine artery embolization under sedation for fibroid disease.

Methods: Thirty-nine patients (mean age 42.3 years) were prospectively randomized 1:1 to receive 20 mg oxycodone or placebo orally immediately before their procedure. At the commencement of the procedure, patients were provided with a patient-controlled analgesia device for 24 h, programmed to deliver 1 mg boluses of intravenous morphine with a 5 min lockout. Mean visual analog scale pain intensity ratings (0-100 mm) were measured from both groups and evaluated over 0 to 6 h as the primary end point. Other measured parameters included opioid-related side effects and eligibility for discharge (NCT00163930; September 12, 2005).

Results: Early pain intensity did not vary significantly between the active and placebo groups [mean (standard deviation): 3.2 (2.5) vs. 3.1 (2.2), p = 0.89]. The oxycodone group, however, experienced significantly more nausea (p = 0.035) and a greater incidence of vomiting (p = 0.044). Overall opioid requirement over 24 h, measured as oral morphine equivalent, was greater in the oxycodone group (median [interquartile range]: 64.5 [45-90] mg vs. 22.5 [15-46.5] mg, p < 0.0001). The number of patients first eligible for discharge at 24 h in the oxycodone group was decreased but not significantly (p = 0.07).

Conclusion: The addition of preprocedural oral oxycodone to morphine patient-controlled analgesia does not offer any analgesic advantage to patients having uterine artery embolization and may cause a greater incidence of nausea and vomiting.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Adult
  • Analgesia, Patient-Controlled / methods*
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / therapeutic use
  • Double-Blind Method
  • Female
  • Humans
  • Leiomyoma / therapy*
  • Morphine / administration & dosage
  • Morphine / therapeutic use*
  • Oxycodone / administration & dosage
  • Oxycodone / therapeutic use*
  • Pain, Postoperative / drug therapy*
  • Prospective Studies
  • Treatment Outcome
  • Uterine Artery Embolization / adverse effects*
  • Uterine Artery Embolization / methods


  • Analgesics, Opioid
  • Morphine
  • Oxycodone

Associated data

  • ClinicalTrials.gov/NCT00163930