INTRODUCTION:
Procedural pain is a clinical manifestation of intense episodic pain (IEP) following an invasive therapeutic procedure. Oxycodone iv has aroused great interest and we propose our clinical experience in patients who are sedated with dexmedetomidine.
 METHODS:
After approval of the Local Ethics Committee and informed consent, we enrolled 20 ICU patients who needed thoracentesis and thoracic drainage. Inclusion criteria were: presence of a pleural effusion (US confirmed) requiring drainage, stable hemodyhnamics, stable sedative profile for at least 12 hourse (patients sedated with dexmedetomidine at 0,5 mcg/kg/h). Patients who required simultaneous administration of other opioids were excluded from the study. Intravenous administration of oxycodone (5 mg bolus) was performed 10 minutes before the start of the procedure. Pain was assessed with NRS in three phases: T0 = start of the procedure; T1 = end of the procedure; T2 = 4 hours from the procedure. An acceptable NRS with a mean value of ≤ 4 was evaluated. In the study we provided a second administration of oxycodone to T2 for those patients with NRS > 4.
RESULTS:
All patients demonstrated and NRS ≤ 4 at T0 and T1. Of these, 13 patients required a second bolus at T2, as they presented NRS > 4. All patients 12-hour after the procedural have a satisfactory NRS < 4.
 CONCLUSIONS:
Oxycodone iv for the control of procedural pain has proved to be a satisfactory approach in the management of procedural pain in patients mildly sedated hospitalized in ICU, reducing the use of other opioid drugs.

INTRAVENOUS OXYCODONE IN PROCEDURAL PAIN