Epidural analgesia is commonly used in labour analgesia and in postoperative pain after major surgery. It is highly effective in severe acute pain, has minimal effects on foetus and newborn, may reduce postoperative complications, and enhance patient satisfaction. In epidural analgesia, low concentrations of local anaesthetics are combined with opioids. Two opioids, morphine and sufentanil, have been approved for epidural use, but there is an interest in evaluating other opioids as well. Oxycodone is one of the most commonly used opioids in acute pain management. However, data on its use in epidural analgesia are sparse. In this narrative review, we describe the preclinical and clinical data on epidural oxycodone. Early data from the 1990s suggested that the epidural administration of oxycodone may not offer any meaningful benefits over intravenous administration, but more recent clinical data show that oxycodone has advantageous pharmacokinetics after epidural administration and that epidural administration is more efficacious than intravenous administration. Further studies are needed on the safety and efficacy of continuous epidural oxycodone administration and its use in epidural admixture.

Background/Objectives: Psychological factors impact patient-reported outcome measures (PROMs). This study assessed the influence of preoperative anxiety, depression, and resilience on postoperative pain interference and life satisfaction one year after spine surgery. Methods: This study was a secondary analysis of a study involving 120 patients who underwent elective spine surgery and were randomly assigned to receive either tramadol–paracetamol (37.5 mg/325 mg; two tablets; n = 61) or placebo (n = 59) twice per day for pain management during the first five postoperative days. Patients completed the Life Satisfaction Scale-4, Brief Pain Inventory, Hospital Anxiety and Depression Scale, and Resilience Scale-14 questionnaires before surgery and at 28 days and 52 weeks post surgery. The primary outcomes were life satisfaction and pain interference at 12 months after spine surgery and their associations with preoperative anxiety, depression, and resilience. Results: Data from 113 patients (94% response rate) were collected at 52 weeks postoperatively. The number of patients reporting satisfaction with their life increased from three (5%) and two (3%) before surgery to 23 (41%) and 19 (34%), while pain interference decreased from a median of 4.1 to 1.2 and from 4.4 to 1.9 on a scale of 0–10 at 12 months in the placebo and tramadol–paracetamol groups, respectively. The linear regression analysis revealed no statistically significant predictive value for preoperative anxiety, depression, or resilience score for life satisfaction and pain interference at 12 months after spine surgery. Conclusions: These results highlight that psychological factors, anxiety, depression, and resilience did not have an impact on postoperative pain outcomes and life satisfaction in patients undergoing spine surgery.