Oliceridine effectively attenuates fentanyl-induced cough during general anesthesia induction

Objective: Fentanyl-induced cough (FIC) is a common adverse event during anesthesia induction with a high incidence and may result in serious clinical complications. Although our clinical observations suggest that oliceridine attenuates FIC, the available evidence remains limited. This study was designed to assess the prophylactic efficacy of oliceridine against FIC and to characterize its peri-induction safety profile. Methods: A total of 168 adult surgical patients with American Society of Anesthesiologists physical status I-III scheduled for general anesthesia were randomized to receive either oliceridine 2 mg (OF group) or normal saline (SF group) prior to fentanyl administration. The primary outcome was the incidence of cough within 1 min following fentanyl injection. Secondary outcomes included cough severity, vital sign changes, and the incidence of adverse events. Results: < 0.001). Cough severity in the SF group was classified as mild (17.86%), moderate (20.24%), and severe (20.24%). Vital signs did not show statistically significant changes from before to after oliceridine injection within each group, and no significant between-group differences were identified. The incidence of adverse events was low in both groups, with no significant between-group differences. Conclusion: Pretreatment with 2 mg oliceridine effectively reduces the incidence of FIC without increasing significant additional risks, providing a rationale and safe approach for anesthetic induction. Clinical trial registration: https://www.chictr.org.cn/showproj.html?proj=272947, identifier ChiCTR2500105221.