Effects of Oliceridine Versus Sufentanil on Hemodynamic Stability in Elderly Hypertensive Patients During Laryngeal Mask Airway Anesthesia: A Randomized Controlled Trial

Purpose: To evaluate the efficacy and safety of low-dose oliceridine versus sufentanil in maintaining hemodynamic stability during laryngeal mask airway (LMA) general anesthesia in elderly hypertensive patients. Patients and Methods: A prospective, double-blind, randomized controlled trial was conducted with 80 elderly hypertensive patients (aged ≥ 65 years, SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg). Participants were randomized into two groups: the oliceridine group (Group O, n = 40) and the sufentanil group (Group S, n = 40). Hemodynamic parameters (SBP, DBP, MAP, HR) were recorded at baseline, after drug administration, and post-LMA placement. Adverse events (eg, hypotension, hypertension, nausea/vomiting) were analyzed using Chi-square or Fisher’s exact tests. Results: Compared with sufentanil, oliceridine significantly reduced the hemodynamic fluctuations after laryngeal mask insertion. Specifically, the variability of mean arterial pressure (MAP) decreased ((ΔMAP: − 4.8 ± 3.4 mmHg vs − 15.7 ± 10.5 mmHg, mean difference: 10.9mmHg, 95% CI: 7.4 to 14.3 mmHg, P = 0.000). Although there was no significant difference in intubation response rate between the two drugs (7.5% vs 10.0%, P = 0.236), oliceridine demonstrated better safety profile, with no occurrence of nausea or vomiting (0% vs 7.5%, P = 0.076). Conclusion: Oliceridine may offer a safer alternative for hemodynamically fragile elderly patients during LMA anesthesia. Keywords: elderly, hemodynamic stability, hypertension, laryngeal mask airway, oliceridine, randomized controlled trial