Comparison of Oliceridine and Morphine in Postoperative Analgesia in Laparoscopic Total Hysterectomy, a Randomized Double-Blind Controlled Trial.

PURPOSE: Compare the analgesic efficacy and safety profiles of oliceridine and morphine in patient-controlled intravenous analgesia (PCIA) after laparoscopic total hysterectomy.

MATERIALS AND

METHODS

This prospective, double-blind trial randomly allocated 60 patients undergoing elective laparoscopic total hysterectomy in a 1:1 ratio to receive either oliceridine (group O) or morphine (group M) via PCIA. The primary endpoint was cough numerical rating scale (NRS) scores 6 h postoperatively. Secondary outcomes included cough/resting NRS scores at 0.5, 2, 6, 12, 24, and 48 h (6 h cough NRS score excluded); 24-hour postoperative recovery quality using 15-item Quality of Recovery (QoR-15) scale. Exploratory indicators including hemodynamic parameters and peripheral capillary oxygen saturation (SpO2) post intravenous analgesic loading dose. Safety indicators represented by the incidence of adverse events occurring within 72 hours postoperatively.

RESULTS

Group O demonstrated superior early analgesia with lower resting NRS (1.0 [1.0,1.0] vs 1.5 [1.0,2.0]; P = 0.019) and cough NRS (1.0 [1.0-2.0] vs 2.5 [1.0-3.0]; P = 0.003) at 0.5 h compared with group M, and analgesic efficacy was comparable thereafter (all P > 0.05). Group O exhibited lower nausea/vomiting (33.3% vs 73.3%, P = 0.002) and constipation (20.0% vs 53.3%, P = 0.007) rates, along with higher 24-h QoR-15 scores (125.27 ± 10.11 vs 119.67 ± 8.49; P = 0.024). Higher SpO2 in group O at 5 min (P = 0.003) and 10 min (P = 0.033) postloading doses. Meanwhile, group M demonstrated transient heart rate (HR) elevation at 5 min postloading dose, whereas group O exhibited no significant HR increases at any time point.

CONCLUSION

Oliceridine demonstrates analgesic efficacy comparable to morphine after laparoscopic total hysterectomy but exhibits superior safety by significantly reducing opioid-related adverse events and potentially accelerating postoperative recovery.