{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T12:05:04Z","timestamp":1793361904832,"version":"4.5.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>Oliceridine (Olinvyk\u00ae Trevena, PA, USA) was approved by the United States Food and Drug Administration for clinical use on Aug 8, 2020. Even though, the indication of its approval is very restrictive (to manage moderate-to-severe acute pain in adults when the pain is severe enough), for such an innovative opioid, off-label indications are bound to abound. What could be described as the \u201copioid of the century,\u201d it aims to overcome some of the stubbornest barriers to opioid prescribing, namely addiction liability, respiratory depression, and gastrointestinal (GI) side effects, just to name a few. The novel opioid accomplishes this by a unique mechanism of action. By selectively acting on the G-protein sub-pathway in preference to the beta-arrestin, it aims to mitigate these unwanted \u00b5-opioid receptors-associated opioid side effects, while preserving its analgesic activity. What remains to be seen, however, is if these observations seen in phases 2 and 3 trials will be borne in actual large-scale clinical use, both inside and outside the USA. Unfortunately, the field of anesthesia is rife with innovations that have shown enormous promise at the research stage, only to end up as damp squibs when released to the clinicians for general use. Rapcuronium and althesin are some such examples. We aim to present some of the contentious and emerging issues associated with this drug and some of the potential pitfalls of this new opioid.<\/jats:p>","DOI":"10.4103\/sja.sja_510_21","type":"journal-article","created":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T11:41:25Z","timestamp":1641296485000},"page":"69-75","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":23,"title":["Oliceridine- Opioid of the 21st Century"],"prefix":"10.4103","volume":"16","author":[{"given":"Basavana","family":"Goudra","sequence":"first","affiliation":[{"name":"Clinical Associate Professor of Anesthesiology and Critical Care Medicine, Perelman School of Medicine, Hospital of the University of Pennsylvania, 680 Dulles, 3400 Spruce Street, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,1,4]]},"reference":[{"key":"R1-20250925","doi-asserted-by":"crossref","first-page":"2180","DOI":"10.1073\/pnas.94.6.2180","article-title":"Receptor and G\u03b2\u03b3 isoform-specific interactions with G-protein-coupled receptorkinases","volume":"94","author":"Daaka","year":"1997","journal-title":"Proc Natl Acad Sci U S A"},{"key":"R2-20250925","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.bbamem.2006.10.021","article-title":"G-Protein coupled receptor structure and activation","volume":"1768","author":"Kobilka","year":"2007","journal-title":"Biochim Biophys Acta"},{"key":"R3-20250925","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/978-3-642-41199-1_22","article-title":"\u03b2-Arrestins: Regulatory role and therapeutic potential in opioid and cannabinoid receptor-mediated analgesia","volume":"219","author":"Raehal","year":"2014","journal-title":"Handb Exp Pharmacol"},{"key":"R5-20250925","first-page":"715","article-title":"APOLLO-2: A randomized, placebo and active-controlled phase III study investigating oliceridine (TRV130), a G-protein-biased ligand at the \u03bc-opioid receptor, for management of moderate to severe acute pain following abdominoplasty","volume":"19","author":"Singla","year":"2019","journal-title":"Pain Pract Off J World Inst Pain"},{"key":"R6-20250925","doi-asserted-by":"crossref","first-page":"927","DOI":"10.2147\/JPR.S171013","article-title":"APOLLO-1: A randomized placebo and active-controlled phase III study investigating oliceridine (TRV130), a G-protein-biased ligand at the \u03bc-opioid receptor, for management of moderate-to-severe acute pain following bunionectomy","volume":"12","author":"Viscusi","year":"2019","journal-title":"J Pain Res"},{"key":"R10-20250925","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1310\/hpj4107-659","article-title":"A comparison of a fentanyl, morphine, and hydromorphone patient-controlled intravenous delivery for acute postoperative analgesia: A multicenter study of opioid-induced adverse reactions","volume":"41","author":"Hutchison","year":"2006","journal-title":"Hosp Pharm"},{"key":"R11-20250925","doi-asserted-by":"crossref","first-page":"e187621","DOI":"10.1001\/jamanetworkopen.2018.7621","article-title":"Prevention of prescription opioid misuse and projected overdose deaths in the United States","volume":"2","author":"Chen","year":"2019","journal-title":"JAMA Netw Open"},{"key":"R12-20250925","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1001\/jamainternmed.2016.3298","article-title":"Incidence of and risk factors for chronic opioid use among opioid-naive patients in the postoperative period","volume":"176","author":"Sun","year":"2016","journal-title":"JAMA Intern Med"},{"key":"R13-20250925","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/j.jamcollsurg.2020.03.025","article-title":"Eliminating opioids from breast conserving surgery: Perioperative pain management pathway","volume":"230","author":"Kang","year":"2020","journal-title":"J Am Coll Surg"},{"key":"R14-20250925","doi-asserted-by":"crossref","first-page":"e5237040","DOI":"10.1155\/2018\/5237040","article-title":"Development of a multimodal analgesia protocol for perioperative acute pain management for lower limb amputation","volume":"2018","author":"De Jong","year":"2018","journal-title":"Pain Res Manag"},{"key":"R15-20250925","doi-asserted-by":"crossref","first-page":"e024086","DOI":"10.1136\/bmjopen-2018-024086","article-title":"Risk factors for opioid-induced respiratory depression in surgical patients: A systematic review and meta-analyses","volume":"8","author":"Gupta","year":"2018","journal-title":"BMJ Open"},{"issue":"5","key":"R16-20250925","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1093\/bja\/aex341","article-title":"Death or near-death in patients with obstructive sleep apnoea: a compendium of case reports of critical complications","volume":"119","author":"Subramani","year":"2017","journal-title":"BJA: British Journal of Anaesthesia"},{"key":"R17-20250925","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1002\/pds.1989","article-title":"Determinants of fentanyl and other potent \u03bc opioid agonist misuse in opioid-dependent individuals","volume":"19","author":"Cicero","year":"2010","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"R18-20250925","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s11916-010-0171-1","article-title":"Opioid-induced hyperalgesia: Clinically relevant or extraneous research phenomenon?","volume":"15","author":"Tompkins","year":"2011","journal-title":"Curr Pain Headache Rep"},{"key":"R19-20250925","doi-asserted-by":"crossref","first-page":"353.e1","DOI":"10.1016\/j.ajog.2016.03.016","article-title":"Persistent opioid use following cesarean delivery: Patterns and predictors among opioid-na\u00efve women","volume":"215","author":"Bateman","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"R20-20250925","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1213\/01.ANE.0000143351.64538.BC","article-title":"Remifentanil: A novel systemic analgesic for labor pain","volume":"100","author":"Evron","year":"2005","journal-title":"Anesth Analg"},{"key":"R21-20250925","doi-asserted-by":"crossref","first-page":"74","DOI":"10.4103\/2249-4472.123298","article-title":"Remifentanil in labor","volume":"3","author":"Goudra","year":"2013","journal-title":"J Obstet Anaesth Crit Care"},{"key":"R22-20250925","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1111\/anae.12099","article-title":"Cardiac arrest in an obstetric patient using remifentanil patient-controlled analgesia","volume":"68","author":"Marr","year":"2013","journal-title":"Anaesthesia"},{"key":"R23-20250925","first-page":"615","article-title":"Current perspectives on intrathecal drug delivery","volume":"7","author":"Bottros","year":"2014","journal-title":"J Pain Res"},{"key":"R24-20250925","doi-asserted-by":"crossref","first-page":"3325","DOI":"10.19082\/3325","article-title":"Effect of entonox on reducing the need for pethidine and the relevant fetal and maternal complications for painless labor","volume":"8","author":"Attar","year":"2016","journal-title":"Electron Physician"},{"key":"R25-20250925","doi-asserted-by":"crossref","first-page":"349","DOI":"10.4103\/sja.SJA_813_19","article-title":"Oliceridine and its potential to revolutionize GI endoscopy sedation","volume":"14","author":"Goudra","year":"2020","journal-title":"Saudi J Anaesth"},{"key":"R26-20250925","doi-asserted-by":"crossref","first-page":"400","DOI":"10.4103\/1319-3767.164202","article-title":"Cardiac arrests in patients undergoing gastrointestinal endoscopy: A retrospective analysis of 73,029 procedures","volume":"21","author":"Goudra","year":"2015","journal-title":"Saudi J Gastroenterol"},{"key":"R27-20250925","doi-asserted-by":"crossref","first-page":"161","DOI":"10.5946\/ce.2016.019","article-title":"Association between type of sedation and the adverse events associated with gastrointestinal endoscopy: An analysis of 5 years' data from a tertiary center in the USA","volume":"50","author":"Goudra","year":"2017","journal-title":"Clin Endosc"},{"key":"R28-20250925","doi-asserted-by":"crossref","first-page":"259","DOI":"10.4103\/1658-354X.115334","article-title":"Outpatient endoscopic retrograde cholangiopancreatography: Safety and efficacy of anesthetic management with a natural airway in 653 consecutive procedures","volume":"7","author":"Goudra","year":"2013","journal-title":"Saudi J Anaesth"},{"key":"R29-20250925","doi-asserted-by":"crossref","first-page":"2466","DOI":"10.1007\/s10620-020-06464-3","article-title":"Medical, political, and economic considerations for the use of MAC for endoscopic sedation: Big price, little justification?","volume":"65","author":"Goudra","year":"2020","journal-title":"Dig Dis Sci"},{"key":"R30-20250925","doi-asserted-by":"crossref","first-page":"2781","DOI":"10.1007\/s10620-020-06044-5","article-title":"Recent developments in drugs for GI endoscopy sedation","volume":"65","author":"Goudra","year":"2020","journal-title":"Dig Dis Sci"},{"key":"R31-20250925","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1213\/ANE.0000000000003662","article-title":"Pharmacological characters of oliceridine, a \u03bc-opioid receptor G-protein-biased ligand in mice","volume":"129","author":"Liang","year":"2019","journal-title":"Anesth Analg"},{"key":"R32-20250925","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1002\/jcph.1076","article-title":"Oliceridine (TRV130), a novel G-protein-biased ligand at the \u03bc-opioid receptor, demonstrates a predictable relationship between plasma concentrations and pain relief. I: Development of a pharmacokinetic\/pharmacodynamic model","volume":"58","author":"Fossler","year":"2018","journal-title":"J Clin Pharmacol"},{"key":"R33-20250925","doi-asserted-by":"crossref","first-page":"2413","DOI":"10.2147\/JPR.S137952","article-title":"A randomized, phase IIb study investigating oliceridine (TRV130), a novel \u03bc-receptor G-protein pathway selective (\u03bc-GPS) modulator, for the management of moderate to severe acute pain following abdominoplasty","volume":"10","author":"Singla","year":"2017","journal-title":"J Pain Res"},{"key":"R36-20250925","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1097\/00000542-200506000-00006","article-title":"Prolongation of QTc interval after postoperative nausea and vomiting treatment by droperidol or ondansetron","volume":"102","author":"Charbit","year":"2005","journal-title":"Anesthesiology"},{"key":"R37-20250925","doi-asserted-by":"crossref","first-page":"87","DOI":"10.4330\/wjc.v5.i4.87","article-title":"Drugs to be avoided in patients with long QT syndrome: Focus on the anaesthesiological management","volume":"5","author":"Fazio","year":"2013","journal-title":"World J Cardiol"},{"key":"R38-20250925","first-page":"1699","article-title":"Etomidate in sepsis: Understanding the dilemma","volume":"7","author":"Gagnon","year":"2015","journal-title":"J Thorac Dis"},{"key":"R39-20250925","first-page":"CD010225","article-title":"Single induction dose of etomidate versus other induction agents for endotracheal intubation in critically ill patients","volume":"1","author":"Bruder","year":"2015","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_510_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:41:29Z","timestamp":1787067689000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_510_21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/sja.sja_510_21","relation":{},"ISSN":["1658-354X","0975-3125"],"issn-type":[{"value":"1658-354X","type":"print"},{"value":"0975-3125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1]]},"assertion":[{"value":"2021-07-07","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-08","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}