Abstract
PURPOSE: To investigate the efficacy and safety of oliceridine for anesthesia induction, maintenance and analgesia in patients undergoing thoracoscopic lobectomy. PATIENTS AND METHODS: In this single-center, prospective, double-blind, randomized controlled trial, patients scheduled for surgery between October 2024 and August 2025 were divided into two groups: oliceridine group (Group O) and sufentanil group (Group S). Study drugs were used for anesthesia induction, maintenance and postoperative analgesia. The primary outcome was the incidence of postoperative opioid-related adverse events within the first 48 hours, including PONV, respiratory depression, dizziness, pruritus, and constipation. Secondary outcomes included hemodynamic parameters, NRS and Ramsay Sedation Scale at multiple time points of post-surgery (2h, 6h, 12h, 24h, and 48h), the usage of postoperative analgesia drugs, rescue treatments, and Quality of Recovery-15 (QoR-15) scores. RESULTS: A total of 166 patients were enrolled (Group O: n=83, Group S: n=83). Compared to Group S, Group O showed significantly lower rates of PONV and respiratory depression (P<0.05) and higher QoR-15 scores at 24h and 48h (P<0.05). No significant differences were found in hemodynamics, NRS scores, or Ramsay scores between the two groups (P > 0.05). CONCLUSION: Oliceridine provides safe and effective perioperative analgesia for patients undergoing thoracoscopic lobectomy. It maintains stable hemodynamics, achieves analgesic efficacy comparable to sufentanil, and demonstrates a superior profile in reducing opioid-related adverse events while promoting postoperative recovery.