Objective  To investigate the effect of different doses of oxycodone on postoperative recovery quality in elderly patients undergoing laparoscopic cholecystectomy.

Methods   Elderly patients scheduled for elective laparoscopic cholecystectomy at Mianyang Central Hospital from September 2023 to April 2024 were selected. Patients were randomly divided into group C, group O1 and group O2. Ten minutes before anesthesia induction, group O1 received intravenous oxycodone 0.05 mg·kg^-1, group O2 received oxycodone 0.1  mg·kg^-1, and group C received an equivalent volume of 0.9% sodium chloride. Observe and compare the scores of the Quality of Recovery-40 (QoR-40) scale at 24 hours postoperatively, the Visual Analogue Scale (VAS) for pain at 10 minutes postoperatively and incidence of postoperative respiratory amnesia among the three groups. Multiple linear regression analysis was used to investigate the effect of hydrocodone on postoperative QoR-40 score.

Results  A total of 117 patients were included, 39 in each group. According to the dropout criteria, a total of 34 cases were included in the group C, 38 cases in group O1, and 38 cases in group O2. Compared to group C, group O1 and O2 showed significantly higher QoR-40 scores at 24 hours postoperatively (P<0.01), particularly in physical comfort, emotional state, independent functioning, and pain (P<0.05 or P<0.01). However, there was no significant difference between group O1 and O2 (P>0.05). Both oxycodone groups had significantly lower 10-minute postoperative VAS scores than group C (P<0.05). Group O1 had a lower incidence of respiratory amnesia than group O2 (P<0.05). Multivariate regression revealed that oxycodone use, age, postoperative nausea/vomiting, and 10-minute VAS scores collectively explained 69% of the variance in QoR-40 scores at postoperatively (adjusted R²=0.69), with oxycodone use significantly improving QoR-40 scores at postoperatively [β=9.336, 95%CI (7.428, 11.243), P<0.001].

Conclusion  Preoperative intravenous administration of oxycodone improves the quality of recovery in elderly patients after laparoscopic cholecystectomy. The incidence of postoperative respiratory amnesia was lower in 0.05 mg·kg^-1 oxycodone dose group.

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