Objective: To investigate the effect of patient-controlled intravenous analgesia (PCIA) with oliceridine on the postoperative quality of recovery in patients undergoing posterior open lumbar surgery.
Methods: Patients aged 18-79 years with BMI 20.0-30.0 kg/m2 and ASA physical status Ⅰ-Ⅲ, who underwent elective posterior open lumbar spine surgery from January to August 2025, were enrolled. They were randomly assigned to two groups using the random number table method: the oliceridine group and the sufentanil group. Thirty minutes before the end of surgery, the oliceridine group received intravenous oliceridine 0.03 mg/kg, while the sufentanil group received intravenous sufentanil 0.2 μg/kg. Immediately after surgery, a intravenous analgesia pump was connected, the oliceridine group received oliceridine 0.3 mg/kg and the sufentanil group received sufentanil 2 μg/kg, both groups combined with flurbiprofen axetil 150 mg and tropisetron 4 mg, diluted with normal saline to a total volume of 100 ml. If the patient's VAS pain score was ≥ 4 after pressing the analgesia pump within 48 hours postoperatively, an additional 50 mg of flurbiprofen axetil was administered intravenously for rescue analgesia. The primary outcome was the 15-item quality of recovery (QoR-15) score at 24 hours postoperatively. The secondary outcomes included resting and activity (coughing) VAS pain score and Bruggrmann comfort scale (BCS) score at 10 minutes after extubation, 6, 12, 24, and 48 hours postoperatively, QoR-15 score at 48 hours postoperatively, the time to first flatus postoperatively, the number of effective presses of the patient-controlled analgesia pump and rescue analgesia within 48 hours postoperatively, the concentrations of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in peripheral blood at 2 hours preoperatively, 24, and 48 hours postoperatively. Adverse reactions included nausea and vomiting, dizziness, abdominal distension within 48 hours postoperatively.
Results: Sixty patients were enrolled in this study, 30 patients in each group. Compared with the sufentanil group, the oliceridine group had a significantly higher total QoR-15 scores, the subscales of pain and physical comfort at 24 hours postoperatively, significantly lower VAS pain scores (resting and during activity) at 6, 12, and 24 hours postoperatively, serum concentrations of IL-6 and TNF-α at 24 hours postoperatively, and incidence of nausea and vomiting at 48 hours postoperatively (P < 0.05). Meanwhile, compared with the sufentail group, the effective pressing times of the PCIA pump and rescue analgesia rate within 48 hours postoperatively were significantly reduced, the BCS scores were significantly increased at 6, 12, and 24 hours postoperatively, and the time to first flatus postoperatively was significantly shortened in the oliceridine group (P < 0.05). There were no significant differences between the two groups in QoR-15 score, resting or during activity VAS pain scores, or serum IL-6 and TNF-α levels at 48 hours postoperatively.
Conclusion: Oliceridine-based PCIA is safe for postoperative analgesia in patients undergoing open posterior lumbar surgery. Compared with sufentanil, oliceridine provides superior analgesic efficacy, reduces adverse reactions such as nausea and vomiting, and improves the postoperative quality of recovery. |
