Effect of multimodal preemptive analgesia on postoperative gastrointestinal function and clinical outcome in patients undergoing laparoscopic colorectal surgery

Abstract

Objective This study aimed to investigate the effects of multimodal preemptive analgesia on postoperative gastrointestinal function and clinical outcomes in patients undergoing laparoscopic colorectal surgery. Methods This prospective study included a total of 108 patients undergoing elective laparoscopic colorectal surgery from June 2019 to June 2020. The patients were divided into the control group and the study group according to the random number table method. Patients in the study group were given flurbiprofen axetil and oxycodone before skin incision combined with bilateral transverse abdominis plane block (TAPB) before anaesthesia induction. In the control group, patients were given sufentanil and flurbiprofen axetil combined with bilateral TAPB in postanaesthesia care unit (PACU). The incidence of postoperative gastrointestinal dysfunction (POGD), I‐FEED score, inflammatory factor levels, rehabilitation indicators, postoperative pain assessment and other organ complications were observed and compared between the two groups. Results The incidence of POGD in the study group was lower compared to the control group, and the difference was statistically significant (P < .05). The study group had lower total and mean scores of I‐FEED at 24, 48, 72 and 96 hours after surgery; however, the differences were not statistically significant (P > .05). On the first and third day after operation, Lipopolysaccharide (LPS), C‐reactive protein (CRP), Tumour necrosis factor (TNF‐α) and Interleukins6 (IL‐6) levels of the study group decreased significantly (P < .05). The reduction in inflammation factor levels from 1d to 3d was significantly greater than that of the control group (P < .05). Conclusion The strategy of multimodal preemptive analgesia can effectively prevent the onset of POGD and may accelerate rehabilitation. In short, multimodal preemptive analgesia provides a novel prevention strategy for patients undergoing laparoscopic colorectal surgery.

Effects of Abdominal Wall Blocks on Postoperative Delirium in Elderly Patients Undergoing Laparoscopic Surgery: A Randomized Controlled Study

“…Our data showed that TAPB and RSB, when performed preoperatively, can reduce the levels of IL-6 and hs-CRP, which is basically consistent with the results of previous studies [ 22 , 44 ]. Preemptive analgesia has been reported to reduce the inflammatory response caused by surgery [ 45 ].…”

[Retracted] Analysis of Interventional Application Effect of Ultrasound‐Guided QLB and TAPB in the Treatment and Analgesia of Patients Undergoing Laparoscopic Colorectal Surgery

“…And intraoperative anesthesia is to ensure that the procedure would be able to give patients the basic conditions in order to alleviate patients' postoperative pain and intraoperative pain with strong stress response, to make patients achieve ideal anesthesia in the operation, and effective anesthesia can help patients with postoperative recovery and reduce the postoperative complications of [ 4 , 5 ]. As one of the effective analgesic methods of anesthesia combined with multimode analgesia technology, TAPB block has achieved good analgesic effect in minimally invasive laparoscopic surgery, which can effectively relieve patients' body pain, but its deficiency is that it cannot be used as visceral analgesia [ 6 , 7 ]. As one of the effective methods of postoperative multimode analgesia technology, ultrasound guided QLB block can improve the deficiency of TAPB and effectively relieve patients' visceral pain, which is widely used in gastrointestinal surgery, gynecological surgery, and other surgeries [ 8 ].…”

An Evidence-Based Medical Review on Promoting Gastrointestinal Function Recovery After Colorectal Cancer Surgery

“…The incidence of postoperative complications was 19.4%. 7 , 8 , 11–14 Therefore, in this study, we sought to summarize the best evidence for accelerating the postoperative recovery of gastrointestinal function in patients with CRC to offer a scientific, standardized, and reliable evidence basis for clinical practice.…”