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The median effective dose of oxycodone for acute postoperative pain after thoracoscopic pulmonary surgery with intercostal nerve blockin in patients of different ages: a dose-finding study protocol

Year: 2025

Type: article

Abstract: Oxycodone is an effective drug for controlling acute postoperative pain (APP), especially visceral pain. However, the effective dose needed for controlling APP depends on the surgical method and the patient age. Therefore, through use of the Dixon up-and-down method, this study investigated the median effective dose (ED 50 ) of oxycodone that could be combined with intercostal nerve block (INB) to effectively control APP after thoracoscopic pulmonary surgery in patients of different ages. This is a prospective, interventional, dose-finding study. Patients undergoing thoracoscopic lobar and sublobar resections under general anaesthesia will be selected and divided into 4 groups according to age and surgical method: the elderly lobectomy group (aged ≥ 65 years), the nonelderly lobectomy group (aged < 65 years), the elderly sublobar resection group (aged ≥ 65 years), and the nonelderly sublobar resection group (aged < 65 years). The study will be performed simultaneously in four experimental groups via the Dixon up-and-down method. The initial dose for the first patient in each group will be set to 0.1 mg/kg; the dose for the next patient will be determined by the response of the previous patient. The primary outcome is the ED 50 of oxycodone. The results of this study are expected to provide an effective strategy for the management of APP following thoracoscopic pulmonary surgery and specifically to offer more accurate dose guidance for the use of oxycodone in older patients. This will not only improve the development of individualized pain management plans but also optimize the patient’s postoperative recovery, reduce unnecessary drug side effects, and increase the overall comfort and quality of life of patients. This study was registered on clinicaltrials.gov (NCT06534801) on August 1, 2024.

Source: BMC Anesthesiology

DOI: 10.1186/s12871-025-03198-5