Effect of Oliceridine on Sufentanil-Induced Cough During General Anesthesia: A Prospective Randomized Controlled...

Sufentanil-induced cough (SIC) frequently occurs during the induction of general anesthesia and may result in serious clinical complications, occasionally posing life-threatening risks. In clinical practice, we observed that oliceridine-a G protein-biased μ-opioid receptor agonist-demonstrates a potent suppressive effect on SIC. This study aimed to evaluate the efficacy of oliceridine in preventing SIC and to assess any associated adverse events.

In this prospective, randomized, double-blind, placebo-controlled trial, 286 adult patients undergoing elective surgery under general anesthesia were enrolled and randomly assigned to receive either 2 mg oliceridine (OS group) or an equal volume of normal saline (SS group) before intravenous administration of sufentanil. The primary outcome was the incidence of SIC. Secondary outcomes included the severity of cough, vital sign changes, and adverse events.

The incidence of SIC was 42.66% in the SS group and 0% in the OS group (95% upper confidence bound ≈ 2.6%; P < 0.001). Among the SS group, mild, moderate, and severe cough occurred in 12.59%, 26.57%, and 3.50% of patients, respectively. No significant differences were observed in systolic or diastolic blood pressure, heart rate, or SpO₂ between the two groups at baseline or 2 minutes post-sufentanil administration. The incidence of adverse events was low and comparable between groups, with no reported cases of apnea, nausea, or vomiting.

Pretreatment with 2 mg oliceridine demonstrated favorable effevtiveness in suppressing SIC without significant adverse effects. Oliceridine appears to be a safe and effective prophylactic strategy for preventing SIC and may have valuable clinical utility in anesthesia practice.