Tolerability of different doses of oliceridine versus traditional opioids in acute pain management: a systematic review and meta-analysis

This study aims to deliver a systematic review and meta-analysis to scrutinize the tolerability of different doses of oliceridine in acute pain patients. A comprehensive search was carried out in essential databases (PubMed, Embase, Cochrane Library, and Web of Science) for relevant studies up to the most recent available date.We included Randomized Controlled Trials (RCTs) that compared oliceridine with other interventions in acute pain management. Patients received an equi-analgesic dose of oliceridine relative to morphine, ensuring comparable Sum of Pain Intensity Differences (SPID-48 or SPID-24) or mean pain score reductions across groups. The initial loading dose was 1.5 mg for oliceridine and 4 mg for morphine, followed by demand doses via patient-controlled analgesia (PCA). For oliceridine, the demand doses were 0.1, 0.35, or 0.5 mg, while for morphine, it was 1 mg.Utilizing the Review Manager 5.4, data on nausea, vomiting, sedation, dizziness, pruritus, and hypoxemia were assembled and evaluated.We conducted sensitivity analyses to confirm the robustness of our findings. The preliminary search discovered 710 potential studies. Having gone through a careful screening process, a total of 7 RCTs met our inclusion benchmarks. Five distinct publications analyzed postoperative nausea and vomiting (PONV). According to our meta-analysis findings, patients assigned to the oliceridine group experienced a notably lower rate of postoperative nausea (PON) and postoperative vomiting (POV) compared to the morphine group (PON: RR = 0.55, 95% CI 0.41-0.74, P < 0.001; POV: RR = 0.36, 95% CI 0.28-0.47, P < 0.001). Data from 4 documents examined sedation and dizziness. Our findings demonstrate that oliceridine recipients had a significant decline in the incidence of both sedation and dizziness (sedation: RR = 0.64, 95% CI 0.45-0.91, P = 0.01; dizziness: RR = 0.71, 95% CI 0.57-0.88, P = 0.002).Moreover, the oliceridine group recorded a lower incident of hypoxemia showcasing a favorable safety profile (RR = 0.52, 95% CI 0.41-0.65, P < 0.001).Sensitivity analyses confirmed the robustness of these findings. The systematic review and meta-analysis reveal that oliceridine is a well-tolerated and safe intravenous analgesic for acute pain patients, often reducing the incidence of adverse events in comparison to morphine.