Effects of oliceridine-based patient-controlled intravenous administration on postoperative pain and hemodynamic stability in elderly patients undergoing laparoscopic surgery for colorectal cancer.

The dose-effect relationship and hemodynamic effects of oliceridine in elderly patients undergoing laparoscopic surgery remain unclear. This study evaluated the effects of different doses of oliceridine administered via patient-controlled intravenous analgesia (PCIA) on postoperative pain management in older adults with colorectal cancer. Patients were divided into three groups according to the analgesic regimen: a control group (Group C, fentanyl PCIA), a low-dose oliceridine group (Group O1), and a high-dose oliceridine group (Group O2), each comprising 50 patients. Outcomes included resting and movement numeric rating scale (NRS) scores, incidence of moderate-to-severe pain, Ramsay sedation scores, Quality of Recovery-15 (QoR-15) scores, patient satisfaction, inflammatory cytokine levels, hemodynamic and respiratory parameters, and adverse reactions. The total opioid load was similar across the three groups. Group O2 showed consistently lower resting and movement NRS scores at all observation time points (all P<0.001). It also had the lowest frequency of moderate-to-severe pain within the first 48 hours after surgery (P<0.05). In addition, patients in the O2 group achieved earlier first ambulation and had a shorter length of hospital stay than the other groups (P<0.05). Group O2 also showed a higher QoR-15 score, indicating better postoperative recovery quality (P<0.001), along with higher analgesic satisfaction (P=0.001). Inflammatory cytokine levels decreased dose-dependently (P<0.001). Hemodynamic parameters were more stable, and respiratory rate and saturation (SpO2) improved more significantly in Group O2 (P<0.05). The incidence of adverse reactions was comparable among the three groups of people (P>0.05). The number of remedial analgesia administrations within 24 hours postoperatively (0.4±0.2 times) and total flurbiprofen axetil consumption (25.0±12.5 mg) were significantly lower in Group O2 than in Groups O1 and C (P<0.05). High-dose Oliceridine PCIA provided better analgesic effects for elderly Laparoscopic Colorectal Cancer Patients after surgery, effectively reduced inflammatory response, and maintained stable Hemodynamic and Respiratory Function.