Efficacy of perioperative inhalational oxytocin on postoperative pain in lower limb fracture surgeries

Postoperative pain management in orthopedic surgeries, particularly after lower limb fractures , remains a challenge. Systemic opioids are commonly used but pose risks of addiction and adverse effects . This study investigates the potential of inhalational oxytocin as an adjunct for pain control. To evaluate the effectiveness of twice-daily inhalational oxytocin administered three days before and two days after surgery in reducing postoperative opioid consumption. A prospective randomized controlled trial was conducted with 36 patients undergoing lower limb fracture surgery. Participants were randomly assigned to two groups: • Group I (control): Received an inhalational placebo. • Group II (oxytocin): Received inhalational oxytocin. Pain scores were assessed using the Visual Analog Scale (VAS), total postoperative morphine consumption, and the time to first analgesic request. Hemodynamic parameters and adverse events were also recorded. Patients in the oxytocin group demonstrated a delayed first analgesic request (12.89 hours vs. 8.05 hours in the control group, p = 0.001) and significantly lower total morphine consumption (3.22 mg vs. 7.39 mg, p = 0.001). VAS scores were significantly lower at 2, 4, and 6 hours postoperatively in the oxytocin group ( p = 0.015, 0.006, 0.001, respectively). No significant differences were observed in mean arterial pressure , heart rate, intraoperative fluid requirements, or adverse events between groups. Inhalational oxytocin effectively reduced postoperative pain and opioid requirements without affecting hemodynamic stability or causing adverse events. These findings suggest its potential as a safe adjunct in postoperative pain management.