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Tegileridine, a novel biased µ-opioid receptor agonist, is gaining attention in moderate-to-severe pain management, but direct comparisons with other opioid analgesics remain limited.
In patients with moderate-to-severe postoperative pain after minimally invasive esophagectomy, tegileridine matches morphine and outperforms oliceridine in pain relief.
Tegileridine, a novel biased µ-opioid receptor agonist, is gaining attention in moderate-to-severe pain management, but direct comparisons with other opioid analgesics remain limited. This study determined the analgesic efficiency of tegileridine vs oliceridine, with morphine as an active control, in patients undergoing minimally invasive esophagectomy (MIE).
In this randomized clinical trial, patients with postoperative moderate-to-severe pain after MIE were allocated in a 2:2:1 ratio to receive tegileridine (0.75 mg), oliceridine (1.5 mg), or morphine (3 mg). Each treatment encompassed a loading dose followed by patient-controlled analgesia (PCA) with the same drug over 48 hours. The primary endpoint was the time-weighted sum of resting pain-intensity difference over 24 hours (rSPID24h), alongside secondary measures such as motion-related pain (mSPID24h), numerical rating scale (NRS) scores, and total pain relief.
Among 75 analyzed patients (morphine n=15; tegileridine n=30; oliceridine n=30), rSPID24h and mSPID24h exhibited no significant differences between groups. However, tegileridine noticeably reduced NRS pain scores at rest and during movement compared with oliceridine (P < 0.01) within 48 hours, while showing comparable potency to morphine (P > 0.05). Total pain relief trends further favored tegileridine and morphine over oliceridine at both 24 hours (P = 0.057) and 48 hours (P = 0.033).
Tegileridine illustrated comparable or slightly superior analgesic efficacy to oliceridine and similar performance to morphine in postoperative pain management after MIE. These findings highlight tegileridine as a promising next-generation opioid analgesic for effective post-surgical pain control.
Drug Design, Development and Therapy
Tegileridine versus Oliceridine for Acute Postoperative Pain Management in Patients After Minimally Invasive Esophagectomy: A Preliminary Randomized Controlled Trial
Yuwei Qiu et al.
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