November 29, 2025
Background: Oliceridine is a G protein-selective μ-opioid receptor agonist with reduced β-arrestin activation that may produce fewer opioid-related adverse effects (ORAEs) than traditional opioids. The VOLITION prospective cohort study evaluated oliceridine for management of postoperative pain and evaluated ORAEs.
Methods: We enrolled 204 patients scheduled for major noncardiac surgery. Our primary aim was to quantify the proportion of patients having respiratory compromise over the initial two postoperative days. Cardiorespiratory function was continuously monitored with pulse oximetry, capnography, and plethysmography. Our composite of clinically meaningful respiratory events was defined by an end-tidal (Et) CO2 ≤15 mmHg for ≥3 min, respiratory rate ≤5 breaths/min for ≥3 min, oxygen saturation ≤85 % for ≥3 min, apnea lasting >30 s, or any life- threatening respiratory events. All potential respiratory events were adjudicated by two independent expert reviewers. On an exploratory basis we evaluated the proportion of patients achieving a complete gastrointestinal response (no vomiting and no rescue antiemetic use). Central nervous system compromise was evaluated with the Richmond Agitation-Sedation Scale, the Pasero Opioid-Induced Sedation Scale, and the 3-min Diagnostic Confusion Assessment Method.
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