{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:53:12Z","timestamp":1782489192395,"version":"3.54.5"},"reference-count":29,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"unspecified","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Teaching Research Project of Tongji Hospital","award":["No. TJJXYJ2023037"],"award-info":[{"award-number":["No. TJJXYJ2023037"]}]},{"DOI":"10.13039\/501100003819","name":"Natural Science Foundation of Hubei Province","doi-asserted-by":"publisher","award":["No.2023AFB912"],"award-info":[{"award-number":["No.2023AFB912"]}],"id":[{"id":"10.13039\/501100003819","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,4,16]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients undergoing thoracoscopic pulmonary resection are prone to moderate-to-severe acute postoperative pain, which not only increases the risk of pulmonary complications but may also lead to chronic postsurgical pain. While traditional opioids provide effective analgesia, they are associated with significant adverse effects. Intercostal nerve block (ICNB) can precisely relieve incisional pain but has a limited duration of action. Tegileridine is a novel biased \u03bc-opioid receptor agonist, offering favourable analgesic efficacy with fewer adverse reactions. Currently, there is a lack of research on the combination of tegileridine and ICNB for analgesia following thoracoscopic pulmonary resection, warranting further clinical exploration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This single-centre, randomised, double-blind, non-inferiority trial is designed to compare the postoperative analgesic efficacy of tegileridine-based patient-controlled intravenous analgesia (PCIA) combined with ICNB versus sufentanil-based PCIA combined with ICNB in patients undergoing thoracoscopic pulmonary resection. A total of 118 participants are enrolled and randomly assigned in a 1:1 ratio to either the tegileridine group or the sufentanil group. The primary outcome is the pain Visual Analogue Scale score during movement within 48 hours postoperatively, with non-inferiority determined using a margin of \u20131 point and 95% CIs. Secondary outcomes include the number of rescue analgesic interventions, PCIA-related parameters (total analgesic consumption, number of effective presses and total number of presses), incidence of opioid-related adverse events (respiratory depression, postoperative nausea and vomiting) and overall patient satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The trial protocol was approved by the Medical Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology on 14 February 2026 (Approval No. 2026-S010). The findings will be disseminated through publication in a peer-reviewed journal and on relevant institutional websites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT07386626\">NCT07386626<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-118277","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T16:00:49Z","timestamp":1777910449000},"page":"e118277","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of tegileridine combined with intercostal nerve block for postoperative analgesia following thoracoscopic pulmonary resection: a study protocol for a randomised controlled trial"],"prefix":"10.1136","volume":"16","clinical-trial-number":[{"clinical-trial-number":"nct07386626","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3836-2472","authenticated-orcid":false,"given":"Hongbo","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0933-0818","authenticated-orcid":false,"given":"Ruochen","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4115-3137","authenticated-orcid":false,"given":"Aijun","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"2026062608312204000_16.5.e118277.1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-2359"},{"key":"2026062608312204000_16.5.e118277.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)00173-X"},{"key":"2026062608312204000_16.5.e118277.3","article-title":"Postoperative pain-related outcomes and perioperative pain management in China: a population-based study","volume":"39","author":"Liu","year":"2023","journal-title":"Lancet Reg Health West Pac"},{"key":"2026062608312204000_16.5.e118277.4","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1213\/ANE.0000000000006452","article-title":"Prevalence and Characteristics of Persistent Postoperative Pain After Thoracic Surgery: A Systematic Review and Meta-Analysis","volume":"137","author":"Wang","year":"2023","journal-title":"Anesth Analg"},{"key":"2026062608312204000_16.5.e118277.5","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezv336"},{"key":"2026062608312204000_16.5.e118277.6","doi-asserted-by":"crossref","DOI":"10.1186\/s13019-025-03734-x","article-title":"Acute postoperative pain management after cardiothoracic surgery: a bibliometric analysis and future directions","volume":"20","author":"Wang","year":"2025","journal-title":"J Cardiothorac Surg"},{"key":"2026062608312204000_16.5.e118277.7","doi-asserted-by":"crossref","DOI":"10.1002\/ejp.4790","article-title":"Cannabinoids for Acute Postoperative Pain Management: A Systematic Review and Meta-Analysis of Clinical Trials","volume":"29","author":"Gonz\u00e1lez C\u00e1rdenas","year":"2025","journal-title":"Eur J Pain"},{"key":"2026062608312204000_16.5.e118277.8","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1016\/j.bja.2025.07.078","article-title":"Genetic variants associated with chronic postsurgical pain: evidence from the China Surgery and Anaesthesia Cohort study","volume":"135","author":"Song","year":"2025","journal-title":"Br J Anaesth"},{"key":"2026062608312204000_16.5.e118277.9","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/ALN.0000000000005818","article-title":"Pain as a Driver of Myocardial Injury in Hip Fracture Patients: A Hip Fracture Accelerated Surgical Treatment and Care Track (HIP ATTACK) Trial Secondary Analysis","volume":"144","author":"Khan","year":"2026","journal-title":"Anesthesiology"},{"key":"2026062608312204000_16.5.e118277.10","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1007\/s40122-024-00648-9","article-title":"The Impact of Different Regional Anesthesia Techniques on the Incidence of Chronic Post-surgical Pain in Patients Undergoing Video-Assisted Thoracoscopic Surgery: A Network Meta-analysis","volume":"13","author":"Zhao","year":"2024","journal-title":"Pain Ther"},{"key":"2026062608312204000_16.5.e118277.11","doi-asserted-by":"crossref","first-page":"111448","DOI":"10.1016\/j.jclinane.2024.111448","article-title":"Comparisons in analgesic effects between ultrasound-guided erector spinae plane block and surgical intercostal nerve block after video-assisted thoracoscopic surgery: A randomized controlled trial","volume":"95","author":"Sung","year":"2024","journal-title":"J Clin Anesth"},{"key":"2026062608312204000_16.5.e118277.12","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1097\/JS9.0000000000002165","article-title":"Comparison of thoracoscopic-guided intercostal nerve block and ultrasound-guided intercostal nerve block in postoperative analgesia of uniportal video-assisted lobectomy: a pilot randomized controlled trial","volume":"111","author":"Li","year":"2025","journal-title":"Int J Surg"},{"key":"2026062608312204000_16.5.e118277.13","doi-asserted-by":"crossref","first-page":"11499","DOI":"10.2147\/DDDT.S565369","article-title":"Tegileridine versus Oliceridine for Acute Postoperative Pain Management in Patients After Minimally Invasive Esophagectomy: A Preliminary Randomized Controlled Trial","volume":"19","author":"Qiu","year":"2025","journal-title":"Drug Des Devel Ther"},{"key":"2026062608312204000_16.5.e118277.14","first-page":"717","article-title":"Tegileridine: First Approval","volume":"84","author":"Dhillon","year":"2024","journal-title":"Drugs (Abingdon Engl)"},{"key":"2026062608312204000_16.5.e118277.15","doi-asserted-by":"crossref","DOI":"10.1016\/j.xcrm.2025.102477","article-title":"Tegileridine for moderate-to-severe acute pain following abdominal surgery: A randomized, double-blind, phase 3 clinical trial","volume":"6","author":"Wang","year":"2025","journal-title":"Cell Rep Med"},{"key":"2026062608312204000_16.5.e118277.16","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2024-081477","article-title":"SPIRIT 2025 statement: updated guideline for protocols of randomised trials","volume":"389","author":"Chan","year":"2025","journal-title":"BMJ"},{"key":"2026062608312204000_16.5.e118277.17","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew466"},{"key":"2026062608312204000_16.5.e118277.18","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1213\/ANE.0000000000002779","article-title":"Efficacy of Ultrasound-Guided Serratus Plane Block on Postoperative Quality of Recovery and Analgesia After Video-Assisted Thoracic Surgery: A Randomized, Triple-Blind, Placebo-Controlled Study","volume":"126","author":"Kim","year":"2018","journal-title":"Anesth Analg"},{"key":"2026062608312204000_16.5.e118277.19","doi-asserted-by":"crossref","first-page":"953","DOI":"10.2147\/JPR.S191263","article-title":"Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery","volume":"12","author":"Semyonov","year":"2019","journal-title":"J Pain Res"},{"key":"2026062608312204000_16.5.e118277.20","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2024-098584","article-title":"Effects of etomidate versus propofol for total intravenous anaesthesia on postoperative quality of recovery in patients undergoing day-case laparoscopic cholecystectomy: protocol for a multicentre, randomised controlled non-inferiority trial","volume":"15","author":"Zhu","year":"2025","journal-title":"BMJ Open"},{"key":"2026062608312204000_16.5.e118277.21","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s40262-017-0569-6","article-title":"Pharmacokinetics of Fentanyl and Its Derivatives in Children: A Comprehensive Review","volume":"57","author":"Ziesenitz","year":"2018","journal-title":"Clin Pharmacokinet"},{"key":"2026062608312204000_16.5.e118277.22","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b13ca2"},{"key":"2026062608312204000_16.5.e118277.23","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1007\/s00540-025-03494-x","article-title":"Prevalence and risk factors of chronic postsurgical pain after lung cancer surgery and knee arthroplasty: a prospective multicenter cohort study in Japan","volume":"39","author":"Sugiyama","year":"2025","journal-title":"J Anesth"},{"key":"2026062608312204000_16.5.e118277.24","doi-asserted-by":"crossref","first-page":"291","DOI":"10.21037\/cdt-24-312","article-title":"Effectiveness of intravenous administration of a combination of sufentanil and esketamine on post-cardiac surgery pain management and depression: a randomized controlled trial","volume":"15","author":"Xu","year":"2025","journal-title":"Cardiovasc Diagn Ther"},{"key":"2026062608312204000_16.5.e118277.25","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1097\/00000542-198807000-00006","article-title":"Analgesic and respiratory effects of epidural sufentanil in patients following thoracotomy","volume":"69","author":"Whiting","year":"1988","journal-title":"Anesthesiology"},{"key":"2026062608312204000_16.5.e118277.26","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1007\/s40122-023-00546-6","article-title":"Intraoperative Sufentanil Consumption and the Risk of Postoperative Nausea and\/or Vomiting: A Retrospective Observational Study","volume":"12","author":"Zhang","year":"2023","journal-title":"Pain Ther"},{"key":"2026062608312204000_16.5.e118277.27","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1213\/ANE.0000000000004833","article-title":"Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting","volume":"131","author":"Gan","year":"2020","journal-title":"Anesth Analg"},{"key":"2026062608312204000_16.5.e118277.28","doi-asserted-by":"crossref","unstructured":"Huang C , Liu B , Xie S , et al . . DDDT 2025;Volume 19:5929\u201339. 10.2147\/DDDT.S532778","DOI":"10.2147\/DDDT.S532778"},{"key":"2026062608312204000_16.5.e118277.29","doi-asserted-by":"crossref","first-page":"10033","DOI":"10.2147\/DDDT.S553848","article-title":"Effect of Oliceridine Combined with Sufentanil on Patient-Controlled Intravenous Analgesia in Elderly Patients After Laparoscopic Radical Resection of Rectal Cancer: A Prospective Randomized Controlled Study","volume":"19","author":"Tian","year":"2025","journal-title":"Drug Des Devel Ther"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2026-118277","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:39:24Z","timestamp":1782488364000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2026-118277"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":29,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,4]]},"published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1136\/bmjopen-2026-118277"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2026-118277","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}