Liver Cancer: Effects, Safety, and Cost-effectiveness of Controlled-Release Oxycodone for Pain Control after TACE

To evaluate the analgesic effect, safety, and cost-effectiveness of controlled-release oxycodone (CRO) to control postoperative pain in patients with liver cancer who are undergoing transarterial chemoembolization.This randomized, double-blind, placebo-controlled, prospective clinical study received institutional review board approval. After written informed consent was obtained, 210 patients with liver cancer were randomized into three groups of 70 patients. Group 1 received 20 mg of CRO, group 2 received 10 mg of CRO, and group 3 received a placebo at 1 hour before transarterial chemoembolization (T(0)) and 12 (T(12)) and 24 (T(24)) hours after T(0). Pain intensity on a numeric rating scale, percentage of patients with each degree of pain, quality of life, adverse reactions, analgesic costs, and hospital stays were evaluated and compared among the three groups.Numeric rating scale scores for pain intensity in group 1 and group 2 were significantly lower than those in group 3 at T(0-12) (P < .001); T(12-24) (P < .001); and T(24-48) (P < .001). When group 1 with group 2 were compared, numeric rating scale scores were significantly lower in group 1 than in group 2 during the period of T(0-12) (P < .001) but were not significantly different at T(12-24) (P = .68) and T(24-48) (P = .10). Analgesic cost and hospital stay were significantly lower in treated groups than in the placebo group. No significant difference was observed in quality of life and adverse events between the treated groups and the placebo group.CRO is effective, safe, and cost-effective in the control of postoperative pain after transarterial chemoembolization for patients with inoperable liver cancer.