Effect of oliceridine on hypoxia during sedated hysteroscopy: a Phase 4 randomized clinical trial.

Summary

In a double-blind randomized trial of 492 women undergoing sedated hysteroscopy, oliceridine halved intraoperative hypoxia versus sufentanil (9.8% vs 19.5%; RR 0.50) and was associated with higher nadir SpO2 and lower supplemental propofol use. Findings support oliceridine as a safer opioid option for sedation in this setting.

Key Findings

• Intraoperative hypoxia incidence was lower with oliceridine vs sufentanil: 9.8% vs 19.5% (RR 0.50; 95% CI 0.32–0.79; p=0.002).
• Nadir oxygen saturation was higher in the oliceridine group (median 99% vs 97%; p<0.001).
• Oliceridine required less intraoperative propofol (median difference 10 mg; p=0.03) and showed favorable respiratory gas metrics.

Clinical Implications

For sedated hysteroscopy, oliceridine may be preferable to sufentanil to reduce intraoperative hypoxia and sedative requirements, particularly in patients at risk for respiratory compromise. Protocols should consider availability, dosing, and monitoring pathways.

Limitations

• Single-center study may limit generalizability to other settings and populations.
• Arterial blood gas and severe hypoxia outcomes were secondary and not fully detailed in the abstract.

Future Directions

Multicenter trials comparing oliceridine to other opioids and non-opioid regimens across diverse procedures and risk strata, with standardized respiratory endpoints and cost-effectiveness analyses.