Abstract
OBJECTIVE: To compare the postoperative analgesic efficacy of oliceridine versus sufentanil in patients undergoing total laparoscopy hysterectomy. METHODS: In this double-blind, randomized controlled trial, 80 patients scheduled for elective total laparoscopy hysterectomy were allocated in a 1:1 ratio to receive postoperative patient-controlled intravenous analgesia (PCIA) with either oliceridine (Group O) or sufentanil (Group S). The primary outcome was the cough Numeric Rating Scale (NRS) score at 6 hours postoperatively. Secondary outcomes included resting and cough NRS scores at 0.5, 2, 6, 12, 24, and 48 hours (excluding the 6-hour cough NRS), number of PCIA attempts, proportion requiring rescue analgesia, total rescue analgesic dose, time to first flatus and ambulation, and 24-hour postoperative recovery quality assessed by the 15-item Quality of Recovery (QoR-15) scale. Exploratory outcomes included hemodynamic parameters within 30 minutes after the analgesic loading dose, anesthesia emergence time, and tracheal extubation time. Safety outcomes comprised the incidence of adverse events within 48 hours postoperatively. RESULTS: No significant differences were found between groups in resting or cough NRS scores at any time point, PCIA attempts, rescue analgesia requirement, rescue tramadol dose, emergence time, or extubation time. However, Group O had a significantly shorter time to first flatus (18.63 ± 3.51 vs 24.70 ± 3.26 hours, P < 0.001) and time to first ambulation (17.95 ± 3.30 vs 20.28 ± 3.76 hours, P = 0.004), a lower overall incidence of adverse events (32.5% vs 62.5%, P = 0.007), and a higher QoR-15 score (120.85 ± 7.15 vs.115.63 ± 6.74, P = 0.001). Additionally, Group O demonstrated better hemodynamic stability than Group S. CONCLUSION: For patients undergoing total laparoscopy hysterectomy, oliceridine provides postoperative analgesic efficacy comparable to sufentanil but is associated with a lower incidence of adverse events and better recovery quality.