{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T05:20:37Z","timestamp":1764566437738,"version":"3.46.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"\n Purpose<\/jats:title>\n \n This study aimed to investigate the impact of different doses of oliceridine on the ED\n 50<\/jats:sub>\n of esketamine during hysteroscopic surgery. The objective was to establish an optimal dosing regimen that facilitates the development of an effective and safe analgesic strategy for this procedure by leveraging the potential synergistic effects between the two drugs.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n The trial was conducted involving 90 patients scheduled for elective hysteroscopy. Participants were allocated into three groups: control (0\u00a0mg oliceridine), group O1 (1\u00a0mg oliceridine), and group O2 (2\u00a0mg oliceridine). Anesthesia was induced with propofol, followed by a continuous infusion of propofol and a preset dose of esketamine. The primary outcome was the ED\n 50<\/jats:sub>\n of esketamine, determined using Dixon\u2019s up-and-down method. Secondary outcomes included recovery time, hemodynamic parameters, pain and sedation scores, and the incidence of adverse events.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The ED\n 50<\/jats:sub>\n of esketamine was 0.76(0.66\u20130.86), 0.45(0.40\u20130.55), and 0.41 (0.31\u20130.59) mg\/kg\/h in the control, group O1 and O2, respectively. Compared with the control, group O1(\n P<\/jats:italic>\n = 0.020) and O2(\n P<\/jats:italic>\n = 0.001) showed significantly shorter recovery time. Hemodynamic stability was comparable across groups, though the effect on HR was observed: bradycardia incidence was higher in group O1 than in the Control (\n P<\/jats:italic>\n = 0.021) but lower in group O2 than in O1(\n P<\/jats:italic>\n = 0.004). Compared to the control, the O1 and O2 groups showed a significantly reduced incidence of both excessive oral secretion (3.7% in group O2 vs. 0.0% in group O1 vs. 32.0% in control,\n P<\/jats:italic>\n = 0.000) and cough (4.3% in group O1 and 0.0% in group O2 vs. 28.0% in the control,\n P<\/jats:italic>\n = 0.002). The combination therapy did not increase respiratory adverse reactions (\n P<\/jats:italic>\n &gt; 0.05), and the 2\u00a0mg of oliceridine appeared to provide optimal balance between efficacy and safety within the limits of this study.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n For hysteroscopic procedures, the co-administration of oliceridine was associated with a lower ED\n 50<\/jats:sub>\n of esketamine. This regimen provided synergistic analgesia, reducing the ED\n 50<\/jats:sub>\n of esketamine to lower deep sedation and accelerate recovery. Furthermore, it improved hemodynamic stability by lowering bradycardia incidence without augmenting respiratory adverse effects.\n <\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n www.chictr.org.cn<\/jats:ext-link>\n , (ChiCTR2500101056); registration date: April 18, 2025.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fphar.2025.1728802","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T05:16:36Z","timestamp":1764566196000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The median effective dose of esketamine with different doses of oliceridine during hysteroscopic surgery"],"prefix":"10.3389","volume":"16","author":[{"given":"Min","family":"Shi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiwei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiafeng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lulu","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lulong","family":"Bo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaolin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1007\/s40122-020-00232-x","article-title":"Low incidence of opioid-induced respiratory depression observed with oliceridine regardless of age or body mass index: exploratory analysis from a phase 3 open-label trial in postsurgical pain","volume":"10","author":"Brzezinski","year":"2021","journal-title":"Pain Ther."},{"key":"B2","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1186\/s12871-024-02790-5","article-title":"Efficacy and safety of remimazolam tosilate in anesthesia for short otolaryngology surgery","volume":"24","author":"Cheng","year":"2024","journal-title":"BMC Anesthesiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2542","DOI":"10.1007\/s11605-022-05450-6","article-title":"Effect of ultrasound-guided transversus abdominis plane block combined with patient-controlled intravenous analgesia on postoperative analgesia after laparoscopic cholecystectomy: a double-blind, randomized controlled trial","volume":"26","author":"Dai","year":"2022","journal-title":"J. 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