Intravenous Oliceridine and Opioid-related Complications

Inclusion Criteria

• ≥18 years old
• American Society of Anesthesiologists physical status 1-4
• Scheduled for major noncardiac surgery expected to last at least 2 hours
• Expected to remain hospitalized at least two postoperative nights
• Scheduled for general endotracheal, spinal anesthesia, or the combination
• Expected to require substantial opioid analgesia, defined as ≥20 mg morphine equivalents
• Expected to have patient-controlled intravenous analgesia.

Exclusion Criteria

• Are demented or otherwise cannot provide valid consent
• Have contraindications to oliceridine
• Used legal or illegal opioids chronically, defined as >15 mg morphine equivalents for >15 days during the month before consenting by history
• Have language, vision, or hearing impairments that may compromise continuous ventilation monitoring
• Have planned epidural anesthesia/analgesia
• Planned spinal morphine administration
• Are designated Do Not Resuscitate, hospice, or receiving end of life therapy
• Are expected to require postoperative mechanical ventilation or ICU admission
• Are expected to receive intrathecal opioids
• Are expected to receive gabapentin, pregabalin or other analgesic adjuvants
• Use oxygen at home
• Are unwilling or unable to comply fully with study procedures (including not tolerating the capnography cannula)
• Are known to be pregnant or breastfeeding
• Use CPAP at home
• Have previously participated in the trial