Effect of Oliceridine on the Acute Postoperative Pain Management After Elective Cesarean Delivery: A Randomized Non-Inferiority Trial.

Purpose: Effective postoperative analgesia following cesarean delivery is crucial for maternal recovery. Sufentanil, commonly administered via patient-controlled intravenous analgesia (PCIA), is associated with dose-dependent adverse effects, particularly gastrointestinal disturbances. Oliceridine, a novel G protein-biased μ-opioid receptor agonist, offers the dual advantage of potent analgesia and a reduced risk of opioid-related adverse events. This study aimed to compare the analgesic efficacy and the incidence of side effects between the G protein-biased μ-opioid receptor agonist oliceridine and the conventional opioid sufentanil. Patients and Methods: In this single-center, randomized, double-blind, non-inferiority trial, women undergoing elective cesarean delivery under combined spinal-epidural anesthesia (CSEA) were randomly assigned to receive either oliceridine or sufentanil via patient-controlled intravenous analgesia (PCIA) for 48 hours postoperatively. The primary outcome was the sum of pain intensity differences over 48 hours (SPID Results: 160 participants were included in the final analysis. The primary outcome, SPID Conclusion: Oliceridine provides non-inferior postoperative analgesic efficacy compared with sufentanil in women undergoing cesarean delivery. Exploratory observations suggested a lower incidence of nausea and higher patient satisfaction in the oliceridine group; these findings are hypothesis-generating and require further validation.