For a study, researchers sought to evaluate the effectiveness of titrating the dosage of oxycodone intravenously in treating severe cancer pain. The second goal was the oral route’s conversion ratio, which was set as the second target.

Patients with cancer who were hospitalized due to significant pain were prospectively evaluated. Previous opioid dosages were noted upon admission (T0). Data from T0 until the end of the observation were gathered using the Edmonton symptom assessment scale (ESAS). Until the first indications of considerable analgesia were noticed, oxycodone intravenous boluses were administered. Then, a continuous intravenous infusion of the effective dosage was administered after being multiplied by six. Once the patient was deemed stable, the daily IV dosage was changed to oral oxycodone using a 1:2 starting ratio. Following that, oral oxycodone dosages were adjusted in accordance with the clinical setting.

Nineteen individuals were evaluated in all. The average effective oxycodone bolus dosage required 9.5 mg (SD 8.0) to produce noticeable pain relief in a mean of 10.4 minutes (SD 3.3). The average daily infusion dosages for the first and last treatments were 51.0 mg/day (with a standard deviation of 40.9) and 69.7 mg/day (with a standard deviation of 76.6), respectively. At various time points, a substantial variation in pain severity was seen (P = 0.0005). After an average of 2.7 days (standard deviation: 1.2) of intravenous oxycodone, conversion to the oral route occurred. The average conversion ratio at the end was 1:2,12 (standard deviation 0.36).

The pain was quickly relieved by titrating the amount of oxycodone intravenously. It was reliable to convert 1:2 between intravenously and orally. The first observation needed to be confirmed by more research.

Reference: jpsmjournal.com/article/S0885-3924(22)00897-1/fulltext