To explore the influence of oliceridine combined with propofol on the anesthetic effect and recovery quality of elderly patients undergoing painless gastroscopy.

A total of 108 elderly patients who underwent painless gastroscopy at Xuzhou First People's Hospital from December 2024 to May 2025 were prospectively selected as the research subjects. They were randomly divided into the observation group (oliceridine combined with propofol anesthesia group) and the control group (propofol anesthesia alone group), with 54 cases in each group according to the random number table method. The heart rate, mean arterial pressure (MAP), and blood oxygen saturation (SpO₂) of two groups of patients before anesthesia induction (T₁), after anesthesia induction (T₂), during gastroscopy insertion (T₃), when gastroscopy reached the duodenal bulb (T₄), and during gastroscopy removal (T₅) were recorded and compared. The anesthesia effects of two groups of patients, including sedation/anesthesia success rate, incidence of motor reactions, and total dose of propofol were compared. The time of awakening and leaving the post-anesthesia care unit (PACU) for two groups, the incidence of postoperative delirium/ agitation were recorded, and the quality of awakening were evaluated. The adverse reactions of both groups of patients during gastroscopy examination and within 24 hours after surgery were recorded.

Compared with T₁, the HR and MAP of T₂, T₃, T₄ and T₅ in both groups decreased (P<0.05); the HR of the observation group at T₃ was higher than that of the control group (P<0.05); the MAP of the observation group at T₅ was higher than that of the control group (P<0.05); the SpO₂ of the observation group at T₂ was higher than that of the control group (P<0.05). The incidence of body movement reaction and the total dosage of propofol in the observation group were lower than those in the control group (P<0.05), while there was no significant difference in the success rate of sedation/anesthesia between the two groups (P>0.05). The recovery time, departure time from PACU, and incidence of postoperative delirium/restlessness in the observation group were lower than those in the control group, with statistically significant difference (P<0.05). The incidence of adverse reactions such as hypoxemia, respiratory depression, nausea and vomiting, and abdominal pain in the observation group was lower than those in the control group (P<0.05).

Oliceridine combined with propofol has a good anesthetic effect and recovery quality in painless gastroscopy for the elderly. While providing effective analgesia, it has a lower risk of respiratory depression and nausea and vomiting.