A Comparison of Tegileridine Fumarate versus Sufentanil on the Quality of Postoperative Recovery After Laparoscopic Sleeve Gastrectomy: A Preliminary Randomized Controlled Trial

Objective: Laparoscopic sleeve gastrectomy (LSG) is associated with substantial postoperative pain and a high rate of postoperative nausea and vomiting. Tegileridine fumarate, a biased μ-opioid receptor agonist, may offer effective analgesia with fewer adverse effects than conventional opioids. This study compared the impact of tegileridine versus sufentanil analgesia on postoperative recovery quality in obese patients. Methods: Seventy-two patients were randomly assigned to either the tegileridine group (group T, n = 36) or the sufentanil group (group S, n = 36). The primary outcome was the Quality of Recovery-15 (QoR-15) score at 24 h postoperatively. Secondary outcomes included: the visual analogue scale (VAS), time to first rescue analgesia, rescue analgesia and antiemetic use, cumulative opioid consumption, incidence of adverse events, and levels of C-reactive protein (CRP) and interleukin-6 (IL-6). Results: The median (IQR) total QoR-15 score of 105.5 (103– 120.8) was higher (p < 0.0001) in the group T compared with the score of 100.5 (93.5– 104) in the group S. Group T demonstrated superior early postoperative analgesia, with lower VAS scores at rest (3.61 ± 0.57 vs. 3.91 ± 0.61, P = 0.033) and during movement (4.86 ± 0.76 vs. 5.23 ± 0.72, P = 0.039). The time to first rescue analgesia was longer in group T compared with group S [38 (32.25– 43.75) minutes vs. 21 (17.25– 30) minutes, P < 0.001]. Group T had a lower incidence of nausea (36% vs. 23%, P < 0.05) and vomiting (11% vs. 33%, P < 0.05). Rescue analgesic demand, PCIA use and CRP or IL-6 levels at any measured time point showed no significant difference. Conclusion: In patients undergoing LSG, tegileridine demonstrated a modest improvement in recovery quality, comparable analgesia, and significantly fewer opioid-related adverse events versus sufentanil. Keywords: tegileridine fumarate, biased μ-opioid receptor agonist, quality of recovery, laparoscopic sleeve gastrectomy