Men LC, Wang LZ, Ma CY, Zhang Y, Han Y. Oxycodone-dexmedetomidine vs fentanyl analgesia in septic patients after gastric perforation surgery. World J Gastrointest Surg 2026; 18(8): 120491 [DOI: 10.4240/wjgs.120491]
Corresponding Author of This Article
Yu Han, Department of Critical Care Medicine, Hejian Branch of Cangzhou Central Hospital, No. 32 Jingkai South Street, Cangzhou 062450, Hebei Province, China. hangyudr@163.com
Research Domain of This Article
Gastroenterology & Hepatology
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research-article
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Men LC, Wang LZ, Ma CY, Zhang Y, Han Y. Oxycodone-dexmedetomidine vs fentanyl analgesia in septic patients after gastric perforation surgery. World J Gastrointest Surg 2026; 18(8): 120491 [DOI: 10.4240/wjgs.120491]
World J Gastrointest Surg. Aug 27, 2026; 18(8): 120491 Published online Aug 27, 2026. doi: 10.4240/wjgs.120491
Oxycodone-dexmedetomidine vs fentanyl analgesia in septic patients after gastric perforation surgery
Lian-Chao Men, Li-Zeng Wang, Cong-Ying Ma, Ying Zhang, Yu Han
Lian-Chao Men, Department of Emergency Medicine, Hejian Branch of Cangzhou Central Hospital, Cangzhou 062450, Hebei Province, China
Li-Zeng Wang, Ying Zhang, Yu Han, Department of Critical Care Medicine, Hejian Branch of Cangzhou Central Hospital, Cangzhou 062450, Hebei Province, China
Cong-Ying Ma, Department of Emergency, Hejian Branch of Cangzhou Central Hospital, Cangzhou 062450, Hebei Province, China
Author contributions: Men LC and Wang LZ contributed to study design, data collection, and statistical analysis; Ma CY participated in patient recruitment and clinical data management; Zhang Y assisted with data analysis and literature review; Han Y supervised the study and critically revised the manuscript. All authors contributed to manuscript preparation, reviewed the final version, and approved it for publication.
AI contribution statement: AI was used solely to polish the language in the preface. All other sections were written entirely without AI assistance.
Supported by Bethune Public Welfare Foundation-Enze Pain Management Medical Research Project, No. ezmr2024-039.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Cangzhou Central Hospital, Hejian Branch, No. 2025-1091-01 (z).
Informed consent statement: The requirement for informed consent was waived by the Ethics Committee of Cangzhou Central Hospital, Hejian Branch, because this was a retrospective study based on anonymized clinical data and involved no additional risk to patients.
Conflict-of-interest statement: All authors declare that they have no conflict of interest related to this study.
Data sharing statement: De-identified participant data are available from the corresponding author upon reasonable request.
Corresponding author: Yu Han, Department of Critical Care Medicine, Hejian Branch of Cangzhou Central Hospital, No. 32 Jingkai South Street, Cangzhou 062450, Hebei Province, China. hangyudr@163.com
Received: February 27, 2026 Revised: March 31, 2026 Accepted: July 15, 2026 Published online: August 27, 2026 Processing time: 170 Days and 14.4 Hours
Abstract
BACKGROUND
Gastric perforation is a life-threatening surgical emergency that frequently leads to sepsis with significant postoperative mortality. Appropriate analgesia management is critical as it influences inflammatory response and clinical outcomes. While fentanyl is widely used, it has limitations including immunosuppression and respiratory depression. The oxycodone-dexmedetomidine combination offers potential advantages with anti-inflammatory and organ-protective properties, but comparative studies in septic patients after gastric perforation surgery are lacking.
AIM
To compare the clinical efficacy and safety of oxycodone combined with dexmedetomidine vs conventional fentanyl analgesia on clinical outcomes in patients with sepsis following gastric perforation surgery.
METHODS
Clinical data from 98 patients with sepsis following gastric perforation surgery at our hospital between March 2019 and October 2024 were retrospectively analyzed. Patients were divided into two groups based on postoperative analgesic protocols: Control group (n = 49, receiving conventional fentanyl analgesia) and intervention group (n = 49, receiving oxycodone combined with dexmedetomidine). Inflammatory markers [procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6)], hemodynamic parameters, sedation and pain scores, organ function indicators, intensive care unit (ICU) stay duration, mechanical ventilation duration, and adverse event rates were compared between the two groups.
RESULTS
Baseline characteristics were comparable between the two groups (P > 0.05). Compared with the control group, the intervention group demonstrated significantly lower levels of PCT, CRP, and IL-6 on postoperative days 3 and 5 (all P < 0.05). Hemodynamic stability was superior in the intervention group, with smaller fluctuations in heart rate and mean arterial pressure (all P < 0.05). Richmond Agitation-Sedation Scale scores indicated better sedation quality in the intervention group, with lower Critical Care Pain Observation Tool scores at all time points (all P < 0.05). The intervention group showed significantly shorter ICU stay duration and mechanical ventilation duration (all P < 0.01). The incidence of delirium was significantly lower in the intervention group compared with the control group (8.2% vs 24.5%, P = 0.031). No significant difference was observed in the incidence of respiratory depression between the two groups (P > 0.05).
CONCLUSION
Oxycodone combined with dexmedetomidine provides superior analgesia and sedation effects compared with conventional fentanyl in patients with sepsis following gastric perforation surgery, effectively reducing inflammatory response, maintaining hemodynamic stability, shortening ICU stay duration, and decreasing the incidence of delirium, demonstrating favorable clinical application value.
Core Tip: Sepsis following gastric perforation surgery is associated with high morbidity and prolonged intensive care unit (ICU) stay. Optimizing postoperative analgesia and sedation may influence inflammatory response and organ recovery in these patients. This retrospective cohort study demonstrates that oxycodone combined with dexmedetomidine provides superior analgesia and sedation compared with conventional fentanyl, with improved inflammatory control, enhanced hemodynamic stability, shorter ICU stay, reduced mechanical ventilation duration, and a lower incidence of delirium. These findings support the clinical value of dexmedetomidine-based multimodal analgesia strategies in septic patients after gastric perforation surgery.
