Aysegul Bilen

Objectives: To evaluate the clinical impact and treatment adaptations during the immediate-release oxycodone hydrochloride shortage. Methods: This retrospective, observational study was conducted during the oxycodone shortage period (May 2024–March 2025) in patients with cancer pain. Pain intensity was assessed using the Numerical Rating Scale (NRS) at baseline (prior to switching, while receiving oxycodone) and at follow-up (after switching to alternative analgesics). Changes in pain intensity were evaluated using within-patient differences (ΔNRS), with clinically meaningful worsening defined as an increase of ≥2 points. Descriptive and inferential statistics were used to summarize patient characteristics and outcomes. Results: Of 300 patients screened, 55 met inclusion criteria (mean age 65.2 ± 11.0 years; 63.6% male). Pain intensity increased significantly following treatment modification during the period of oxycodone unavailability, with mean NRS scores rising from 4.3 ± 1.7 to 5.9 ± 2.5 (p < 0.001). The mean ΔNRS was +1.56 (95% CI 0.79–2.34), with clinically meaningful worsening observed in 36 patients (65.5%). No statistically significant association was observed between substitute analgesic type and clinically meaningful worsening (p = 0.11). Conclusions: The oxycodone shortage was associated with worsened pain control and increased need for treatment modifications in cancer patients, highlighting the importance of uninterrupted access to essential opioids.

Purpose This study aimed to investigate whether preoperative anxiety levels influence the incidence and severity of chronic postoperative pain in patients undergoing inguinal hernia repair. Methods A prospective observational study was conducted in 75 adult patients scheduled for elective inguinal hernia repair under general anesthesia. Preoperative anxiety was assessed using the State-Trait Anxiety Inventory (STAI). Pain intensity and characteristics were evaluated with the Numeric Rating Scale (NRS) at 24 h, 1 month, 3 months, and 6 months postoperatively. Chronic postoperative pain was defined as pain persisting for ≥ 3 months. Statistical analyses included Spearman correlation and logistic regression to identify predictors of chronic pain. The primary outcome was the incidence of chronic postoperative pain (CPSP), defined as NRS ≥ 1 at ≥ 3 months. Effect sizes are reported with 95% confidence intervals. Results Of 75 enrolled patients, 64 completed the 6-month follow-up. Chronic postoperative pain was reported in 46.9% at 3 months and 39.1% at 6 months, with 25% experiencing moderate-to-severe pain (NRS ≥ 4) at 6 months. Persistent pain at 6 months was predominantly neuropathic in nature. Higher preoperative STAI-State and STAI-Trait scores were significantly correlated with pain intensity at 1, 3, and 6 months (p < 0.001). Multivariate logistic regression identified the STAI-State score as an independent predictor of chronic pain, with each 1-point increase raising the odds by 40% (OR 1.40, 95% CI 1.20–1.64). Conclusion Preoperative anxiety was associated with chronic postoperative pain after inguinal hernia repair. These findings highlight an association and underscore the need for larger multicenter studies with longer follow-up. Trial registration Not applicable.