Effect of multimodal opioid-sparing anesthesia on intestinal function and prognosis of elderly patients with hypertension after colorectal cancer surgery

• Published in: BMC surgery 2024-10, Vol.24 (1), p.341-9, Article 341
• Main Authors: Ma, Yan-Kai, Qu, Li, Chen, Nan, Chen, Zhe, Li, Yin, Jiang, A Li Mu, Ismayi, Alimujiang, Zhao, Xiao-Liang, Xu, Gui-Ping
• Format: Article
• Language: English
• Subjects: Aged; Aged patients; Albumin; Albumins; Analgesia; Analgesia, Patient-Controlled - methods; Analgesics; Analgesics, Opioid - administration & dosage; Analgesics, Opioid - therapeutic use; Analysis; Anesthesia; Anesthesia, General - methods; Anesthetics; Anesthetics, Local - administration & dosage; Blood pressure; C-reactive protein; Cancer; Cancer patients; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - surgery; Complications; Contraindications; Defecation; Dexmedetomidine; Drug dosages; Female; Health aspects; Heart beat; Heart rate; Hospitals; Humans; Hypertension; Hypertension - etiology; Infiltration; Intestinal function; Intestine; Intestines; Intubation; Leukocytes; Local anesthetics; Male; Medical prognosis; Middle Aged; Multimodal anesthesia; Narcotics; Older people; Open surgery for colorectal cancer; Opioid-sparing; Opioids; Pain management; Pain perception; Pain, Postoperative - diagnosis; Pain, Postoperative - etiology; Patients; Pharmaceuticals; Postoperative; Prognosis; Random numbers; Recovery time; Remifentanil; Remifentanil - administration & dosage; Sample variance; Sufentanil; Surgery; Surgical outcomes; Tumors; Uighurs; Ultrasonic imaging; Vomiting
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-024-02604-y

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