奥赛利定与舒芬太尼静脉自控镇痛对老年胸腔镜肺切除术后疼痛和恢复质量的比较研究

doi:10.3969/j.issn.1003-9198.2026.06.013

摘要/Abstract

摘要： 目的比较奥赛利定与舒芬太尼静脉自控镇痛用于老年患者胸腔镜肺切除术后的镇痛效果,并评估其对患者术后恢复质量的影响。方法选取2025年8—11月择期行胸腔镜肺切除术患者154例作为研究对象,按随机数表法分为奥赛利定组和舒芬太尼组。奥赛利定组和舒芬太尼组术后分别接受奥赛利定和舒芬太尼静脉自控镇痛。采用疼痛强度差异时间加权总和(SPID)比较2组给予负荷剂量后0～48 h的镇痛效果;记录2组患者镇痛泵按压次数、术后补救镇痛例数及术后24 h和48 h 15项术后恢复质量评分(QoR-15);记录术后首次下床活动时间、术后住院时间和不良反应。结果奥赛利定组在给予负荷剂量后0～24 h、24～48 h内的SPID最小二乘平均值均明显低于舒芬太尼组(P＜0.05)。奥赛利定组的镇痛泵有效按压次数与补救镇痛例数均明显少于舒芬太尼组(均P＜0.05)。与舒芬太尼组相比,奥赛利定组在术后24、48 h的QoR-15评分更高,且首次下床活动时间显著缩短(均P＜0.05),2组术后住院时间差异无统计学意义(P＞0.05)。奥赛利定组术后恶心发生率明显低于舒芬太尼组(P＜0.05),2组术后呕吐、便秘、头晕、瘙痒和严重呼吸抑制发生率差异均无统计学意义(均P＞0. 05)。结论与舒芬太尼相比,奥赛利定用于老年患者胸腔镜肺切除术后静脉自控镇痛可有效缓解术后疼痛,减少术后恶心发生,并提升术后恢复质量。

关键词: 奥赛利定, 胸腔镜肺切除术, 术后镇痛, 恢复质量, 老年人

Abstract: Objective To compare the efficacy of oliceridine and sufentanil for patient-controlled intravenous analgesia (PCIA) in elderly patients after thoracoscopic pulmonary surgery, and to evaluate their impact on postoperative recovery quality. Methods A total of 154 patients scheduled for thoracoscopic lung resection from August to November 2025 were enrolled and randomly assigned to oliceridine group and sufentanil group. After surgery, the oliceridine group received PCIA with oliceridine, while the sufentanil group received PCIA with sufentanil. The analgesic effect within 0-48 h after the loading dose of PCIA was compared between the two groups using the time-weighted sum of pain intensity difference (SPID). The following parameters were recorded: the pressing time of analgesic pump, cases of postoperative rescue analgesia, 15-item Quality of Recovery (QoR-15) scores 24 h and 48 h after operation, time to first ambulation, postoperative hospital stay, and adverse reactions. Results The least squares (LS) mean of SPID during 0-24 h and 24-48 h were significantly lower in the oliceridine group than those in the sufentanil group (P<0.05). The oliceridine group also showed a lower pressing time of analgesic pump and fewer rescue analgesia cases(both P<0.05). Compared with the sufentanil group, the oliceridine group had higher QoR-15 scores 24, 48 h after operation and a shorter time to first ambulation (P<0.05). There was no significant difference in postoperative hospital stay between the two groups (P>0.05). The incidence of postoperative nausea was lower in the oliceridine group (P< 0.05), while no significant differences were observed in postoperative vomiting, constipation, dizziness, pruritus, or severe respiratory depression between the two groups (P>0.05). Conclusions Compared with sufentanil, oliceridine for PCIA after thoracoscopic pulmonary resection in elderly patients provides more effective pain relief, reduces postoperative nausea, and improves the quality of postoperative recovery.

Key words: oliceridine, thoracoscopic pulmonary resection, postoperative analgesia, recovery quality, aged

中图分类号:

R 619

蔡永亮, 孙合亮, 江逸豪, 王忠云. 奥赛利定与舒芬太尼静脉自控镇痛对老年胸腔镜肺切除术后疼痛和恢复质量的比较研究[J]. 实用老年医学, 2026, 40(6): 607-612.

CAI Yongliang, SUN Heliang, JIANG Yihao, WANG Zhongyun. Comparison of patient-controlled intravenous analgesia with oliceridine or sufentanil on postoperative pain and quality of recovery in elderly patients after thoracoscopic pulmonary resection[J]. Practical Geriatrics, 2026, 40(6): 607-612.

参考文献

[1] HU J H, ZHONG Z Z, SHI H J, et al. Esketamine vs. placebo combined with erector spinae plane block vs. intercostal nerve block on quality of recovery following thoracoscopic lung resection: a randomized controlled factorial trial[J]. Int J Surg, 2025, 111(1): 677-685.
[2] BATCHELOR T J P, RASBURN N J, ABDELNOUR-BERCHTOLD E, et al. Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERAS©) Society and the European Society of Thoracic Surgeons (ESTS)[J]. Eur J Cardiothorac Surg, 2019, 55(1): 91-115.
[3] ZHANG A, ZHOU Y, ZHENG X, et al. Effects of S-ketamine added to patient-controlled analgesia on early postoperative pain and recovery in patients undergoing thoracoscopic lung surgery: a randomized double-blinded controlled trial[J]. J Clin Anesth, 2024, 92: 111299.
[4] TONG Y, WEI P, WANG S, et al. Characteristics of postoperative pain after VATS and pain-related factors: the experience in National Cancer Center of China[J]. J Pain Res, 2020, 13: 1861-1867.
[5] RAZI S S, STEPHENS-MCDONNOUGH J A, HAQ S, et al. Significant reduction of postoperative pain and opioid analgesics requirement with an enhanced recovery after thoracic surgery protocol[J]. J Thorac Cardiovasc Surg, 2021, 161(5): 1689-1701.
[6] WICK E C, GRANT M C, WU C L. Postoperative multimodal analgesia pain management with nonopioid analgesics and techniques: a review[J]. JAMA Surg, 2017, 152(7): 691-697.
[7] FENG X, YANG P, LIAO Z, et al. Comparison of oxycodone and sufentanil in patient-controlled intravenous analgesia for postoperative patients: a meta-analysis of randomized controlled trials[J]. Chin Med J, 2023, 136(1): 45-52.
[8] 刘川, 潘一鸣, 于文华, 等. 临床生理弹性评估量表在老年住院病人中的信效度检验[J]. 实用老年医学, 2025, 39(1): 37-40, 45.
[9] SIMONS P, VAN DER SCHRIER R, VAN LEMMEN M, et al. Respiratory effects of biased ligand oliceridine in older volunteers: a pharmacokinetic-pharmacodynamic comparison with morphine[J]. Anesthesiology, 2023, 138(3): 249-263.
[10] GAN T J, WASE L. Oliceridine, a G protein-selective ligand at the μ-opioid receptor, for the management of moderate to severe acute pain[J]. Drugs Today, 2020, 56(4): 269-286.
[11] ZHONG Y, XU Y, LEI Q, et al. HSK21542 in patients with postoperative pain: two phase 3, multicentre, double-blind, randomized, controlled trials[J]. Nat Commun, 2025, 16(1): 4830.
[12] ZHAO Y, LU Z, SONG X, et al. Efficacy and safety of SHR8554 on postoperative pain in subjects with moderate to severe acute pain following orthopedic surgery: a multicenter, randomized, double-blind, dose-explored, active-controlled, phase Ⅱ/Ⅲ clinical trial[J]. Pharmacol Res, 2025, 212: 107576.
[13] ZHANG Y E, XU X, GONG R. Postoperative pain management outcomes at a Chinese hospital: a cross-sectional survey[J]. J Perianesth Nurs, 2023, 38(3): 434-439.
[14] HANDFORTH C, CLEGG A, YOUNG C, et al. The prevalence and outcomes of frailty in older cancer patients: a systematic review[J]. Ann Oncol, 2015, 26(6): 1091-1101.
[15] MARKHAM A. Oliceridine: first approval[J]. Drugs, 2020, 80(16): 1739-1744.
[16] 郭磊, 姜文霞, 汪贺, 等. 奥赛利定静脉自控镇痛对老年胸腔镜肺癌切除术的有效性及安全性[J]. 中国老年学杂志, 2025, 45(14):3378-3381.
[17] 米琰, 郭怡辛, 刘世娅, 等. 不同背景剂量奥赛利定用于骨肿瘤切除术后患者自控静脉镇痛的效果[J]. 临床麻醉学杂志, 2025, 41(8): 797-802.
[18] KE Z, HE Y, HU Q, et al. A comparison of the effects of oliceridine and sufentanil on the quality of recovery after hysteroscopic surgery: a prospective double-blind randomized controlled trial[J]. J Anesth, 2025. DOI:10. 1007/s00540-025-03578-8.
[19] TIAN Y, HU J, PAN H, et al. Effect of oliceridine combined with sufentanil on patient-controlled intravenous analgesia in elderly patients after laparoscopic radical resection of rectal cancer: a prospective randomized controlled study[J]. Drug Des Devel Ther, 2025, 19: 10033-10043.
[20] MENG Y, YUAN S, ZHANG H, et al. Comparison of oliceridine and sufentanil in patient - controlled intravenous analgesia for post - thoracoscopic nausea and vomiting: a prospective, double - blind, randomized controlled trial[J]. Front Pharmacol, 2025, 16: 1576154.
[21] UNALDI H E. Effects of mobilization within the first 4 h following anatomical lung resection with thoracotomy[J]. Updates Surg, 2023, 75(7): 2027-2031.
[22] 张瑶, 姚献强, 朱运河, 等. 帕洛诺司琼与托烷司琼预防老年患者腹腔镜宫颈癌根治术后恶心呕吐的效果比较[J]. 实用老年医学, 2016, 30(4): 302-304.
[23] MA B, LI Y, LENG C, et al. A comparative evaluation of the safety and efficacy of oliceridine and sufentanil in gastrointestinal endoscopy: a single-center, randomized controlled trial[J]. Drug Des Devel Ther, 2025, 19: 5111-5121.