Objective To evaluate the efficacy of oliceridine for patient-controlled intravenous anal-gesia(PCIA)after lung surgery.Methods In this single-center,retrospective cohort study,patients of ei-ther sex,aged 18-80 yr,with American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ,with a body mass index of 18-28 kg/m2,who underwent elective lung surgery with PCIA at Shanghai Chest Hospi-tal from January 1,2023 to August 15,2024,were enrolled.Based on the drug components used in PCIA,patients were divided into traditional opioid group(sufentanil or hydromorphone,etc.)and oliceridine group.Patients'demographics,surgery-and anesthesia-related data,and visual analogue scale scores for pain,and opioid-related adverse reactions at 24 h postoperatively were obtained from the anesthesia specialty database.The primary outcome was the incidence of moderate to severe pain(visual analogue scale score≥ 4)at rest assessed within 24 h postoperatively.Secondary outcomes were the occurrence of opioid-related adverse reac-tions within 24 h postoperatively.Data were analyzed after adjusting for baseline imbalances using propensity score matching.Results After matching,3 053 patients were ultimately included in each group.Compared to traditional opioid group,the incidence of moderate to severe pain was significantly decreased within 24 h after surgery(RR:1.298,95％confidence interval:1.120-1.503,P＜0.001),and the incidence of moderate to se-vere PONV was decreased in oliceridine group(RR:1.432,95％confidence interval:1.096-1.871,P=0.008).There was no significant difference in the incidence of dizziness and hypoxemia between the two groups(P＞0.05).Conclusions Oliceridine provides better efficacy for PCIA than traditional opioids in pa-tients undergoing lung surgery.
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