Tang JC, Ma JW, Jian JJ, Shen J, Cao LL. Effect of different anesthetic modalities with multimodal analgesia on postoperative pain level in colorectal tumor patients. World J Gastrointest Oncol 2024; 16(2): 364-371 [PMID: 38425386 DOI: 10.4251/wjgo.v16.i2.364]
Corresponding Author of This Article
Jia-Wei Ma, MD, Doctor, Department of Critical Care Medicine, Central Hospital Affiliated to Jiangnan University, No. 1800 Lihu Avenue, Wuxi 214122, Jiangsu Province, China. mjw081x@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Feb 15, 2024; 16(2): 364-371 Published online Feb 15, 2024. doi: 10.4251/wjgo.v16.i2.364
Effect of different anesthetic modalities with multimodal analgesia on postoperative pain level in colorectal tumor patients
Ji-Chun Tang, Jia-Wei Ma, Jin-Jin Jian, Jie Shen, Liang-Liang Cao
Ji-Chun Tang, Jin-Jin Jian, Liang-Liang Cao, Department of Anesthesiology, The Affiliated Hospital of Jiangnan University, Wuxi 214122, Jiangsu Province, China
Ji-Chun Tang, Department of Anesthesiology, People's Hospital of Aheqi County, Kizilsu Kirgiz Autonomous Prefecture 843599, Xinjiang Uygur Autonomous Region, China
Jia-Wei Ma, Department of Critical Care Medicine, Jiangnan University Medical Center, Wuxi 214122, Jiangsu Province, China
Jia-Wei Ma, Department of Critical Care Medicine, People's Hospital of Aheqi County, Kizilsu Kirgiz Autonomous Prefecture, 843599, Xinjiang Uygur Autonomous Region, China
Jie Shen, Department of Anesthesiology, Jiangyuan Hospital Affiliated to Jiangsu Institute of Atomic Medicine, Wuxi 214063, Jiangsu Province, China
Author contributions: Wang CL and Liang L contributed equally to this work; Wang CL, Liang L, Fu JF, Zou CC, Hong F and Wu XM designed the research study; Wang CL, Zou CC, Hong F and Wu XM performed the research; Xue JZ and Lu JR contributed new reagents and analytic tools; Wang CL, Liang L and Fu JF analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Institutional review board statement: The Institutional Review Board at our hospital approved the study (Approval No. 32432891).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jia-Wei Ma, MD, Doctor, Department of Critical Care Medicine, Central Hospital Affiliated to Jiangnan University, No. 1800 Lihu Avenue, Wuxi 214122, Jiangsu Province, China. mjw081x@163.com
Received: September 7, 2023 Peer-review started: September 7, 2023 First decision: September 26, 2023 Revised: November 11, 2023 Accepted: December 25, 2023 Article in press: December 25, 2023 Published online: February 15, 2024 Processing time: 148 Days and 6.3 Hours
Abstract
BACKGROUND
According to clinical data, a significant percentage of patients experience pain after surgery, highlighting the importance of alleviating postoperative pain. The current approach involves intravenous self-control analgesia, often utilizing opioid analgesics such as morphine, sufentanil, and fentanyl. Surgery for colorectal cancer typically involves general anesthesia. Therefore, optimizing anesthetic management and postoperative analgesic programs can effectively reduce perioperative stress and enhance postoperative recovery. The study aims to analyze the impact of different anesthesia modalities with multimodal analgesia on patients' postoperative pain.
AIM
To explore the effects of different anesthesia methods coupled with multi-mode analgesia on postoperative pain in patients with colorectal cancer.
METHODS
Following the inclusion criteria and exclusion criteria, a total of 126 patients with colorectal cancer admitted to our hospital from January 2020 to December 2022 were included, of which 63 received general anesthesia coupled with multi-mode labor pain and were set as the control group, and 63 received general anesthesia associated with epidural anesthesia coupled with multi-mode labor pain and were set as the research group. After data collection, the effects of postoperative analgesia, sedation, and recovery were compared.
RESULTS
Compared to the control group, the research group had shorter recovery times for orientation, extubation, eye-opening, and spontaneous respiration (P < 0.05). The research group also showed lower Visual analog scale scores at 24 h and 48 h, higher Ramany scores at 6 h and 12 h, and improved cognitive function at 24 h, 48 h, and 72 h (P < 0.05). Additionally, interleukin-6 and interleukin-10 levels were significantly reduced at various time points in the research group compared to the control group (P < 0.05). Levels of CD3+, CD4+, and CD4+/CD8+ were also lower in the research group at multiple time points (P < 0.05).
CONCLUSION
For patients with colorectal cancer, general anesthesia coupled with epidural anesthesia and multi-mode analgesia can achieve better postoperative analgesia and sedation effects, promote postoperative rehabilitation of patients, improve inflammatory stress and immune status, and have higher safety.
Core Tip: The use of general anesthesia coupled with epidural anesthesia and multimodal analgesia in patients with colorectal cancer can effectively reduce postoperative pain, improve recovery, and enhance immune function. This approach provides superior analgesic and sedative effects, as well as improved inflammatory stress and immune status, ensuring patient safety and promoting postoperative rehabilitation.
