Impact of oliceridine versus sufentanil on postoperative nausea and vomiting in patients undergoing thyroid surgery: a prospective, double-blind, randomized controlled trial.
Oliceridine may reduce the incidence of postoperative nausea and vomiting compared to sufentanil in patients undergoing thyroid surgery, but further research is needed to confirm these findings in different surgical contexts.
Where it sits
this study against the rest of the vip (vasoactive intestinal polypeptide) corpusSummary and findings
This study measured the incidence and severity of postoperative nausea and vomiting (PONV) in 232 patients undergoing thyroid surgery, comparing oliceridine to sufentanil. Oliceridine was associated with a lower incidence of PONV within 48 hours postoperatively. The results indicated that oliceridine may reduce opioid-related adverse events compared to sufentanil.
Abstract
<h4>Purpose</h4>Postoperative nausea and vomiting (PONV) is a common complication following thyroid surgery, often exacerbated by opioid use. Oliceridine, a novel G protein-biased μ-opioid receptor agonist, may reduce opioid-related adverse events. This study aimed to compare the impact of oliceridine versus sufentanil on the incidence and severity of PONV in patients undergoing thyroid surgery.<h4>Patients and methods</h4>In this prospective, double-blind, randomised controlled trial conducted between May 2025 and February 2026, 232 patients scheduled for thyroid surgery were randomly assigned to receive either oliceridine or sufentanil for intraoperative analgesia. The primary outcome was the incidence of PONV during the first 48 h postoperatively. Secondary outcomes included PONV severity, need for rescue anti-emetics, postoperative pain scores, recovery quality, and other adverse events.<h4>Results</h4>The incidence of PONV within 48 h postoperatively was significantly lower in the oliceridine group [13/107 (12%)] compared with the sufentanil group [31/110 (28%)] (OR = 0.35, 95% CI: 0.17-0.72, <i>p</i> = 0.006). Postoperative pain scores, rescue analgesia requirements, and Quality of Recovery-15 scores were comparable between the two groups (<i>p</i> > 0.05). Besides, exploratory unadjusted analyses revealed fewer rescue anti-emetics: O group 8/107 (8%) <i>vs</i> S group 25/110 (23%) (OR = 0.27, 95% CI: 0.12-0.64, <i>p</i> = 0.002); and less abdominal distension: O group 4/107 (4%) <i>vs</i> S group 19/110 (17%) (OR = 0.19, 95% CI: 0.06-0.57, <i>p</i> = 0.001).<h4>Conclusion</h4>For young ASA I-II patients undergoing thyroid surgery, oliceridine yields adequate postoperative analgesia and lower PONV rates versus sufentanil. Additional trials involving high-intensity surgical procedures are needed to confirm consistent equivalence.
Background
Postoperative nausea and vomiting (PONV) is a frequent complication after thyroid surgery, often worsened by opioid analgesics. Previous studies have indicated that different opioids may have varying effects on PONV incidence. This study aims to evaluate the efficacy of oliceridine, a G protein-biased μ-opioid receptor agonist, in reducing PONV compared to sufentanil.
Methods
This was a prospective, double-blind, randomized controlled trial involving 232 patients scheduled for thyroid surgery. Participants were randomly assigned to receive either oliceridine or sufentanil for intraoperative analgesia. The primary outcome was the incidence of PONV during the first 48 hours postoperatively, with secondary outcomes including PONV severity and postoperative pain scores.
Results
The primary endpoint showed that the incidence of PONV within 48 hours postoperatively was significantly lower in the oliceridine group at 12% compared to 28% in the sufentanil group (OR = 0.35, 95% CI: 0.17-0.72, p = 0.006). Additionally, fewer patients in the oliceridine group required rescue anti-emetics (8% vs 23%, OR = 0.27, 95% CI: 0.12-0.64, p = 0.002) and experienced abdominal distension (4% vs 17%, OR = 0.19, 95% CI: 0.06-0.57, p = 0.001).
Interpretation
The findings suggest that oliceridine may be more effective than sufentanil in reducing PONV in the studied population. However, while the results are statistically significant, the clinical relevance of the effect sizes, particularly in broader surgical contexts, remains uncertain. Limitations such as the specific patient population and the need for further validation in diverse surgical settings must be considered.
Key findings
- Incidence of PONV within 48 h postoperatively was 12% in the oliceridine group vs 28% in the sufentanil group, OR = 0.35, 95% CI: 0.17-0.72, p = 0.006.
- Fewer rescue anti-emetics were needed in the oliceridine group: 8/107 (8%) vs 25/110 (23%), OR = 0.27, 95% CI: 0.12-0.64, p = 0.002.
- Less abdominal distension was reported in the oliceridine group: 4/107 (4%) vs 19/110 (17%), OR = 0.19, 95% CI: 0.06-0.57, p = 0.001.
Limitations
- limited to young ASA I-II patients
- small sample size of 232
- single surgical type (thyroid surgery)
- short follow-up period of 48 hours
- no assessment of long-term outcomes