Influence of Oliceridine on the Incidence of Postoperative Nausea and Vomiting in High-Risk Patients Stratified Using Apfel Score After General Anesthesia: A Prospective, Randomized Controlled Clinical Study.

TL;DR

In a randomized controlled trial of 279 high-risk patients undergoing laparoscopic surgery, oliceridine (a G-protein-biased μ-opioid agonist) reduced postoperative nausea and vomiting compared to fentanyl, with lower nausea incidence (12.9% vs 26.4%), reduced vomiting (6.5% vs 24.3%), and decreased antiemetic rescue requirements.

Key findings

• Oliceridine reduced postoperative nausea incidence to 12.9% versus 26.4% with fentanyl (p=0.005)
• Vomiting rates were significantly lower with oliceridine at 6.5% versus 24.3% with fentanyl (p<0.001)
• Lower nausea VAS scores (1.40 vs 2.01, p=0.013) and reduced antiemetic rescue rate (7.2% vs 17.1%, p=0.011) in oliceridine group
• Hemodynamic stability and postoperative recovery were comparable between groups

Why this matters at the bedside

Oliceridine may offer a pharmacologic advantage over fentanyl for reducing PONV in high-risk surgical patients undergoing general anesthesia, potentially improving postoperative satisfaction and reducing need for rescue antiemetic interventions.