Effect of multimodal opioid-sparing anesthesia on intestinal function and prognosis of elderly patients with hypertension after colorectal cancer surgery.
Humans
Male
Female
Aged
Colorectal Neoplasms
/ surgery
Hypertension
/ etiology
Analgesics, Opioid
/ therapeutic use
Prognosis
Pain, Postoperative
/ etiology
Anesthesia, General
/ methods
Middle Aged
Analgesia, Patient-Controlled
/ methods
Remifentanil
/ administration & dosage
Intestines
Anesthetics, Local
/ administration & dosage
Hypertension
Intestinal function
Multimodal anesthesia
Open surgery for colorectal cancer
Opioid-sparing
Journal
BMC surgery
ISSN: 1471-2482
Titre abrégé: BMC Surg
Pays: England
ID NLM: 100968567
Informations de publication
Date de publication:
29 Oct 2024
29 Oct 2024
Historique:
received:
13
09
2023
accepted:
30
09
2024
medline:
30
10
2024
pubmed:
30
10
2024
entrez:
30
10
2024
Statut:
epublish
Résumé
Colorectal cancer (CRC) surgery in elderly patients with hypertension poses challenges due to potential complications and prolonged recovery. This study aimed to assess the impact of multimodal opioid-sparing anesthesia on intestinal function and prognosis of elderly hypertension patients undergoing CRC surgery. A total of 80 elderly hypertension patients who underwent open surgery for CRC in the People's Hospital of Xinjiang Uygur Autonomous Region from October 2020 to October 2022 were selected and randomly divided into two group (A and B, n = 40) through the random number table method. Group A received multimodal opioid-sparing anesthesia, defined as low-dose opioid general anesthesia combined with a transversus abdominis plane block, incision infiltration with local anesthetics, and postoperative analgesia via a patient-controlled analgesia (PCA) pump, with the remifentanil dose set at one-third (± 10%) of the conventional group's dose. Group B received conventional opioid anesthesia, involving standard general anesthesia maintained with remifentanil at 0.4-0.5 µg/(kg·min), incision infiltration with local anesthetics, and postoperative PCA. Primary outcomes included mean arterial pressure (MAP) and heart rate (HR), changes in albumin, C-reactive protein (CRP) and white blood cell (WBC), indicators of intestinal function recovery (the recovery time of bowel sounds, the first exhaust time, the first defecation time and the feeding recovery time), and visual analogue scale (VAS) pain scores. Second outcomes included postoperative complications and total hospital stays. After excluding 8 patients, 72 were included in the final analysis. Compared with patients in the B group, patients in the A group exhibited shorter recovery time of bowel sounds, first exhaust time and feeding recovery time (P < 0.05), higher levels of postoperative albumin, and lower levels of CRP and WBC (P < 0.05). Moreover, the incidence of nausea and vomiting was lower and the total hospital stays were fewer in the A group than in the B group (P < 0.05). Multimodal opioid-sparing anesthesia contributes to rapid recovery of postoperative intestinal function and reduction of postoperative adverse reactions. Therefore, it is safe and feasible to apply multimodal opioid-sparing anesthesia to elderly hypertension patients receiving open surgery for CRC.
Identifiants
pubmed: 39472848
doi: 10.1186/s12893-024-02604-y
pii: 10.1186/s12893-024-02604-y
doi:
Substances chimiques
Analgesics, Opioid
0
Remifentanil
P10582JYYK
Anesthetics, Local
0
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
341Subventions
Organisme : Autonomous Region Key R&D Program Project "Research on the Prevention and Treatment System and Key Technologies of Elderly Related Diseases
ID : 2022B03009-4
Informations de copyright
© 2024. The Author(s).
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