Oxycodone (Burns — Background Analgesia)

How it works

It is an agonist principally at mu-opioid receptors, reducing ascending nociceptive signalling and modifying the central perception of pain.

Prescribing in practice

• As a strong opioid it carries risks of respiratory depression, sedation and dependence, so titrate carefully, monitor sedation and respiration, and have naloxone available, especially when combined with procedural opioids.
• It provides background cover and must be paired with separate rapid-onset analgesia for dressing changes and debridement rather than relying on dose increases of the background opioid alone.
• Clearance is reduced in renal and hepatic impairment, requiring lower frequency and closer monitoring, as relevant in major burns with organ dysfunction.

Monitoring

Monitor pain scores, sedation, respiratory rate and bowel function, reviewing the background regimen against procedural opioid use.

Counselling the patient

• This is your steady, around-the-clock painkiller, with separate medicine for dressing changes.
• Tell staff if you feel very drowsy or short of breath.
• Constipation is expected, so take the laxatives offered.

Evidence & guidelines

Background opioids such as oxycodone within a multimodal regimen are supported by burn-care analgesia guidance.