Oxycodone (Orthopaedic Post-operative Pain)

How it works

It is a mu-opioid receptor agonist (with some kappa activity) that reduces central pain transmission and perception.

Prescribing in practice

• Observe for respiratory depression and excessive sedation, especially when combined with other CNS depressants or in opioid-naive patients after surgery.
• Reduce dose in hepatic and renal impairment and in the elderly, where clearance is reduced.
• Use a clear stop or review plan with laxative and antiemetic cover to avoid prolonged post-operative opioid use.

Monitoring

Monitor pain, sedation and respiratory rate, and review the ongoing need as acute post-operative pain settles.

Counselling the patient

• May cause drowsiness; avoid driving or operating machinery if affected.
• Take regular laxatives to prevent constipation.
• Do not combine with alcohol or other sedating medicines.

Evidence & guidelines

UK perioperative pain guidance supports short-course strong opioids within multimodal analgesia, minimising dose and duration after orthopaedic surgery.