{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T05:56:03Z","timestamp":1776405363967,"version":"3.51.2"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The global cesarean section (CS) rate is on the rise, with ratio of repeat CS becoming more common in China following the two-child policy. Postoperative visceral pain, particularly intense in repeat CS parturients and exacerbated by oxytocin, remains inadequately managed. Oxycodone, acting via \u03ba-opioid receptors, has shown promise in relieving visceral pain, but its efficacy in repeat CS populations is unclear, which was explored in this study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This randomized controlled trial enrolled 100 parturients undergoing elective repeat CS, randomized to patient-controlled intravenous analgesia (PCIA) with oxycodone (50 mg\/100 ml) or sufentanil (100 \u03bcg\/100 ml). Primary outcomes were maximum visceral pain Numerical Rating Scale (NRS) scores during 0\u201324 h postoperatively. Secondary outcomes included visceral pain NRS during oxytocin administration on postoperative days 1\u20132, postoperative inflammatory markers (neutrophil-to-lymphocyte ratio, NLR), time to autonomic activity and PCIA presses. This trial was registered with the Chinese Clinical Trial Registry (ChiCTR2400087624; July 31 2024)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significantly lower maximum visceral pain NRS scores in the oxycodone group during 24h after surgery compared to sufentanil group (2.2 \u00b1 0.6\n                      <jats:italic>vs<\/jats:italic>\n                      . 3.4 \u00b1 0.7,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), and also at all time points during oxytocin infusion (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). The oxycodone group also had shorter time to autonomic activity (23.7 \u00b1 5.1 vs. 26.3 \u00b1 3.4 h,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.004), lower postoperative NLR (7.2 \u00b1 2.1 vs. 9.1 \u00b1 3.7,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.003), and fewer PCIA presses (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.002). Multivariate linear regression confirmed oxycodone as an independent predictor of reduced maximum postoperative pain (adjusted \u03b2 = \u22121.13, 95%CI:\u22121.41 to\u22120.85,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In conclusion, oxycodone effectively alleviates postoperative visceral pain and mitigates inflammatory responses in repeat CS parturients, making it a preferred choice for postoperative analgesia in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1787893","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T05:20:14Z","timestamp":1776403214000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of oxycodone in managing visceral pain among women undergoing repeat cesarean section: a randomized controlled trial"],"prefix":"10.3389","volume":"13","author":[{"given":"Qiwei","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University","place":["Chongqing, China"]},{"name":"Department of Anesthesiology, Chongqing Hospital of Jiangsu Province Hospital","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shishi","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University","place":["Chongqing, China"]},{"name":"Department of Anesthesiology, Chongqing Hospital of Jiangsu Province Hospital","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangyou","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengjie","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Second Affiliated Hospital, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiqi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University","place":["Chongqing, 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