Oliceridine for Analgesia in Elderly Patients Undergoing Kyphoplasty: From a Clinical Trial

As a G protein-biased μ-opioid receptor agonist, oliceridine can offer a relatively effective and safe analgesia. However, its effect on patients suffering from kyphoplasty was unexplored.

This study was aimed to determine the median effective dose (ED₅₀) of oliceridine for analgesia during kyphoplasty in elderly patients across different age groups, providing clinical evidence for the optimal administration method.

This prospective study included a total of 105 elderly patients with osteoporotic vertebral compression fractures (OVCFs) who underwent elective percutaneous kyphoplasty (PKP). The included subjects were divided into young age group (65-74 years old), middle age group (75-84 years old), and old age group (≥ 85 years old). The ED₅₀ of oliceridine was determined by Dixon's up-down sequential method. The manifestations of intraoperative analgesic insufficiency were defined as a Numerical Rating Scale (NRS) score ≥ 4, presence of body movement, an increased heart rate, or systolic and diastolic blood pressure > 20% from baseline during balloon dilation or bone cement injection.

When combined with remimazolam, the ED₅₀ value of oliceridine for intraoperative analgesia during PKP was 0.035, 0.030, and 0.027 mg/kg in the young age group, middle age group, and old age group, respectively. The required ED₅₀ in the young-old group was significantly higher than that in the old age group.

The ED₅₀ of oliceridine for intraoperative analgesia during PKP was varied from different age among these elderly patients. The lowest ED₅₀ value in the old age group suggested that an increasing age might be associated with enhanced analgesic potency of oliceridine. The specific mechanism needs to be further elucidated in the future.

Chinese Clinical Trial Register: ChiCTR2400095085.