Oliceridine PCA non-inferior to sufentanil for knee arthroplasty pain, with lower nausea and vomiting

PURPOSE: Oliceridine is a G protein-biased μ-opioid receptor agonist, maintaining potent analgesic effects and simultaneously lessening disadvantageous reactions. This study is intended to compare Oliceridine and sufentanil patient-controlled analgesia (PCA) for postoperative analgesia in elderly patients suffering from knee arthroplasty. PATIENTS AND METHODS: A total of 138 patients scheduled for knee arthroplasty were randomized to receive postoperative PCA with either Oliceridine (2 μg kg mL) or sufentanil (0.02 μg kg mL). To preserve blinding, identical volume-based settings (mL) were used for both groups. The PCA regimen comprised a 1 mL loading dose (equivalent to 2 μg kg Oliceridine or 0.02 μg kg sufentanil), a background infusion of 2 mL h, and a 2 mL bolus dose with a 10-minute lockout interval. Outcomes for systematic assessment included the sum of pain intensity difference (SPID), numeric rating scale (NRS) scores, and the incidence of postoperative nausea, vomiting and respiratory depression. RESULTS: Subjects in this research were 71.5 years on average, and 83% were female. Throughout 48 h postoperatively, the mean difference between Group Oliceridine and Group sufentanil was -7.13 (95% CI: -24.26 to 10.00); the upper bound of the 95% CI did not exceed the pre-specified non-inferiority margin of 10, thereby meeting the non-inferiority criterion. Aside from that, nausea (33.33% vs. 50.72%; P = 0.039) and vomiting (14.49% vs. 34.78%; P = 0.006) presented much lower incidence in Group Oliceridine within 48 h postoperative. CONCLUSION: Oliceridine may have non-inferior analgesic efficacy to sufentanil and is associated with a lowered incidence of nausea and vomiting within 48 h.