The Physicain and provider use of oxycodone to manage pain has been controversial because of the risks that opioid medications pose, including the significant risk for addiction. With growing recognition of the danger of oxycodone, there has become a higher burden of proof to justify the use of the drug to manage pain.

A new study published in PLoS One has focused on one of our most vulnerable populations: children. Specifically, the study investigated the relative effects and safety of oxycodone and ibuprofen for managing pain relating to fractures in children. The data for the study were drawn from the pediatric emergency department of the Stollery Children’s Hospital and included data from between June 2010 and July 2014 from children 329 between the ages of 4 and 16.

Of the 329 children prescribed pain medication following fractures, 112 were prescribed oxycodone, whereas 213 were prescribed ibuprofen. Significantly more children on oxycodone experienced adverse events when compared to those on ibuprofen, suggesting that ibuprofen is likely a safer way to manage pain in these children. Indeed, more than 70% of those taking oxycodone experience an adverse event on the first day of pain management.

In addition to experiencing more adverse events, those on oxycodone were functionally more significantly impacted than those on ibuprofen as well. On the first day of their medication, 83% of those on oxycodone had a function such as eating, playing, sleeping, or performing academic work disrupted.

Based on these results, coupled with the observation that children on oxycodone and ibuprofen experienced a similar level of pain reduction, the authors of the study conclude that oxycodone does not appear to provide any specific advantage over ibuprofen for managing fracture-related pain in children. 

Reference

Ali, S. et al. An observational cohort study comparing ibuprofen and oxycodone in children with fractures. PloS one. 2021;16(9). doi:10.1371/JOURNAL.PONE.0257021