目的 评价奥赛利定应用于老年全膝关节置换术（TKA）术后患者自控静脉镇痛（PCIA）的效果及安全性。 方法 采用前瞻性、双盲、单中心、随机对照设计，纳入84例择期全麻下TKA患者，随机分为奥赛利定组与舒芬太尼组（各42例），均行术后48 h PCIA。主要结局指标为术后24 h静态视觉模拟评分法（VAS）评分，次要结局指标为术后6、12、24、48 h静态和动态VAS评分；术后首次按压PCIA时间、术后48 h内PCIA有效按压次数（D1）、术后48 h内PCIA总按压次数（D2）、D1/D2比值、补救镇痛发生率；拔管后5、10、20、30 min Ramsay镇静评分、术前24 h及术后24、48 h恢复质量量表-15（QoR-15）评分、术前1晚及术后第1、2晚阿森斯失眠量表（AIS）评分、满意度评分、术后住院时间；术后48 h内不良事件发生情况（恶心呕吐、呼吸抑制、尿潴留、头晕等）。 结果 奥赛利定组与舒芬太尼组所有时间点的VAS评分、Ramsay评分、镇痛泵按压相关指标及补救镇痛发生率比较，差异均无统计学意义（P > 0.05）。奥赛利定组D1/D2比值、术后24、48 h QoR-15评分、满意度评分均高于舒芬太尼组（P < 0.05），术后第1晚AIS评分、恶心呕吐发生率低于舒芬太尼组（P < 0.05）。 结论 本研究在TKA患者中系统比较了奥赛利定与舒芬太尼作为PCIA用药的镇痛效能及安全性，结果显示奥赛利定不仅镇痛效果与舒芬太尼相当，更在安全性及舒适度等方面具有明显优势，奥赛利定显著降低了术后恶心呕吐发生率，并提升了术后恢复质量、睡眠质量及总体满意度。

Objective To investigate the efficacy and safety of Oselidine in patient-controlled intravenous analgesia （PCIA） for elderly patients after total knee arthroplasty （TKA）. Methods A prospective， double-blind， single-center， randomized controlled study design was employed. A total of 84 patients who were undergoing elective TKA under general anesthesia were recruited and randomly allocated to either the oseltidine group or the sufentanil group， with 42 cases in each group. All patients received PCIA 48 hours after the operation. The primary endpoint was the static visual analogue scale （VAS） score 24 hours after the operation， while the secondary endpoints were the static and dynamic VAS scores at 6， 12， 24， and 48 hours after the operation. The time of the first PCIA pressing after operation， the effective number of PCIA pressings within 48 h after operation （D1）， the total number of PCIA pressings within 48 h after operation （D2）， the ratio of D1 to D2， and the incidence of remedial analgesia. The Ramsay sedation scores at 5， 10， 20， and 30 min after extubation， the Quality of Recovery-15 （QoR-15） scores at 24 h before operation， 24 h， and 48 h after operation， the Athens Insomnia Scale （AIS） scores on the night before operation， the first night， and the second night after operation， the satisfaction score， and the postoperative hospital stay. Adverse events （such as nausea and vomiting， respiratory depression， urinary retention， dizziness， etc.） that occurred within 48 h after surgery. Results There were no significant differences in VAS score， Ramsay score， analgesia pump pressing - related indexes， and the incidence of remedial analgesia between the two groups at all time points （P > 0.05）. The D1/D2 ratio， QoR-15 scores at 24 and 48 h after operation， and the satisfaction score in the oseltidine group were higher than those in the sufentanil group （P < 0.05）. The AIS score on the first night after operation and the incidence of nausea and vomiting in the oseltidine group were lower than those in the sufentanil group （P < 0.05）. Conclusions This study systematically compared the analgesic efficacy and safety of oxycodone and sufentanil as PCIA drugs in patients with TKA. Results indicate that oxycodone not only provides analgesia comparable to sufentanil but also demonstrates significant advantages in terms of safety and patient comfort. Oxycodone significantly reduced the incidence of postoperative nausea and vomiting， while enhancing the quality of postoperative recovery， sleep quality， and overall patient satisfaction.