1. 2021;24;E309-E315Gastrointestinal Adverse Events in Hospitalized Patients Following Orthopedic Surgery: Tapentadol Immediate Release Versus Oxycodone Immediate Release
   Retrospective Study
   Charlotte Johnstone, MBChB, Jonathan Penm, PhD, Xinyi Wang, BPharm, Sujita W. Narayan, PhD, and Asad E. Patanwala, PharmD.

BACKGROUND: Tapentadol has relatively less effect on mu-opioid receptors compared with other opioids. This has the potential to reduce the occurrence of gastrointestinal (GI) adverse drug events (ADEs).

OBJECTIVES: To compare the GI ADEs during hospitalization between tapentadol immediate release (IR) and oxycodone IR following orthopedic surgeries.

STUDY DESIGN: Retrospective cohort study.

SETTING: A major metropolitan tertiary referral hospital in Australia.

METHODS: Data for adult orthopedic surgery patients receiving postoperative tapentadol IR or oxycodone IR during hospitalization between January 1, 2018 and June 30, 2019, were collected from electronic medical records. The primary outcome was the occurrence of postoperative GI ADEs occurring during hospitalization. This was defined as a composite of nausea, vomiting, or constipation.

RESULTS: The study cohort included 199 patients. Of these, 99 patients received tapentadol IR and 100 patients received oxycodone IR for postoperative pain during hospitalization. The mean age was 66 ± 12 years, and 111 patients (56%) were women. There was no significant difference between groups on the occurrence of GI ADEs (53% in oxycodone group and 51% in tapentadol group, difference 2%, 95% confidence interval [CI], –11% to 16%; P = 0.777). After adjusting for potential confounders, the use of tapentadol IR was not associated with a significant reduction of GI ADEs (odds ratio, 0.62; 95% CI, 0.32–1.20; P = 0.154).

LIMITATIONS: This was a single-center study and should be extrapolated with caution. As this was a retrospective study, the accuracy and availability of data were dependent on documentation in electronic medical records.

CONCLUSIONS: Tapentadol IR is associated with similar GI ADE occurrence compared with oxycodone IR in patients with orthopedic postoperative pain during hospitalization.

KEY WORD: Opioid analgesics, tapentadol, oxycodone, orthopedic procedures, postoperative pain, acute pain, gastrointestinal adverse drug events, opioid-induced adverse drug events