Yongliang Cai, Yihao Jiang, Qingwei Zhang, Jianjun Yang, Zhongyun Wang, Heliang Sun Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210000, Peopleâs Republic of ChinaThese authors contributed equally to this workCorrespondence: Heliang Sun; Zhongyun Wang, Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital with Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu, 210000, Peopleâs Republic of China, Email njmu528@163.com; zywang1970@126.comPurpose: To compare oliceridine with sufentanil for the proportion of elderly patients achieving satisfactory analgesia with minimal emesis (SAME) after thoracoscopic lung surgery.Methods: This prospective, double-blind, randomized controlled trial enrolled elderly patients aged 65â 80 years scheduled for thoracoscopic lung surgery to receive patient-controlled intravenous analgesia with either oliceridine or sufentanil. The primary outcome was the proportion of patients achieving SAME within the first 3 postoperative days, defined as a daily average coughing numerical rating scale (NRS) pain score < 4 and daily highest postoperative nausea and vomiting (PONV) score < 2. The secondary outcomes included NRS pain scores, rescue analgesia, 15-item Quality of Recovery (QoR-15) scores, safety outcomes, time to ambulation, and postoperative length of stay.Results: Among the 247 patients analyzed, oliceridine was associated with a higher proportion of patients achieving the SAME endpoint within the first 3 postoperative days compared with sufentanil (46.3% vs 32.3%; P = 0.023). Furthermore, the patients with oliceridine demonstrated lower NRS scores on POD1 (3.6 ± 1.9 vs 4.4 ± 2.1; P = 0.018) and POD2 (3.2 ± 1.2 vs 3.7 ± 1.3; P = 0.039), less requirement for rescue analgesia (P = 0.021), and higher QoR-15 scores on POD1 (P < 0.001) and POD2 (P = 0.010). Oliceridine also reduced the time to first ambulation (19 h 16, 22 vs 22 h 18, 25; P < 0.001). No significant difference was observed in postoperative length of stay or safety outcomes.Conclusion: Oliceridine, compared with sufentanil for postoperative analgesia, increased the proportion of achieving SAME within the first 3 PODs, provided better analgesia, and improved postoperative recovery quality with comparable safety outcomes for elderly patients undergoing thoracoscopic lung surgery.Trial Registration: www.chictr.org.cn, ChiCTR2500102213.Keywords: oliceridine, sufentanil, SAME, QoR-15, thoracoscopic lung surgery
Cai et al. (Fri,) studied this question.