Hydrocodone vs Oxycodone and Postoperative Pain and Opioid Use in Joint Arthroplasty

Is oxycodone associated with superior postoperative pain control compared with hydrocodone among cytochrome P450 2D6 (CYP2D6) normal metabolizers undergoing joint arthroplasty?In this cohort study including 663 participants receiving multimodal analgesia, hydrocodone was associated with small but significantly lower composite pain scores and significantly lower cumulative opioid consumption than oxycodone. These results were consistent across sensitivity and subgroup analyses.These findings suggest that among CYP2D6 normal metabolizers undergoing joint arthroplasty and receiving multimodal analgesia, hydrocodone provides comparable analgesia to oxycodone with markedly lower opioid exposure.

Corresponding Author: Julie A. Johnson, PharmD, Clinical and Translational Science Institute, The Ohio State University, 376 W 10th Ave, Prior Hall, Ste 260, Columbus, OH 43210 (julie.johnson@osumc.edu).

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