Evaluation of the analgesic efficacy of dinalbuphine sebacate in transoral robotic surgery for obstructive sleep apnea-hypopnea syndrome: a single-center retrospective cohort study.

Abstract

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a chronic disorder with significant comorbidities. Transoral robotic surgery (TORS) combined with uvulopalatopharyngoplasty (UPPP) is an established treatment, but postoperative pain management remains challenging. This study evaluates the efficacy of dinalbuphine sebacate (DNS), an extended-release analgesic, in reducing opioid use and managing postoperative pain in TORS UPPP patients. This retrospective cohort included consecutive TORS-UPPP patients from 1 January 2020 to 30 June 2024; the database was locked on 30 June 2024 prior to analysis. The patients were divided into a DNS group (n = 96) and a conventional analgesia (CA) group (n = 42). The DNS group received a 150 mg intramuscular injection after anesthetic induction and after the surgery. Analgesic consumption, opioid usage, and pain scores were evaluated from the day of surgery (POD0) to two days postoperatively (POD2), as well as opioid prescriptions at discharge and during the first follow-up. The DNS group exhibited a significantly lower percentage of opioid use during POD0-POD2 (30.21% vs. 54.76%, p < 0.001) and a reduced oral morphine equivalent dose (15.31 ± 36.68 mg vs. 56.79 ± 85.83 mg, p = 0.001). Opioid prescriptions at discharge (68.75% vs. 88.10%, p = 0.016) and at the first follow-up (13.54% vs. 52.38%, p < 0.001) were also lower in the DNS group, with comparable analgesic effects. DNS effectively reduces postoperative opioid consumption and prescription in TORS UPPP patients without significant adverse effects. These findings support the integration of DNS into multimodal analgesia protocols for OSAHS surgery, substantially reduced inpatient and post-discharge opioid use (NNT ≈ 3-5) with small, likely non-clinically important differences in pain scores and no significant safety signal, supporting its clinical relevance in OSAHS surgical programs. Warranting further multicenter validation.