Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2025; 17(8): 105990
Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.105990
Ultrasound-guided quadratus lumborum block with general anesthesia for perioperative circulatory stability in colorectal cancer surgery
Hui-Jie Li, Xi Ban, Jing Li, Su-Qin Huang
Hui-Jie Li, Xi Ban, Jing Li, Department of Anesthesiology, Shulan (Quzhou) Hospital, Quzhou 324000, Zhejiang Province, China
Su-Qin Huang, Department of Anesthesiology, Zhejiang Shuren University Shulan International Medical College Affiliated Shulan (Hangzhou) Hospital, Hangzhou 310000, Zhejiang Province, China
Author contributions: Li HJ conceptualized this study; Ban X contributed to data collection; Li HJ and Huang SQ jointly drafted the initial draft and contributed to the formal analysis; Li J provided guidance and contributed to the methodology and visualization of this study; Li HJ, Ban X, and Huang SQ jointly validated this study and edited the entire content of the manuscript.
Institutional review board statement: This study has been reviewed and approved by the Ethics Review Committee of Shulan (Quzhou) Hospital (No. SLYL-2023-219).
Informed consent statement: This study was approved by the patients or their guardians.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No available data.
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: Su-Qin Huang, MD, Chief Physician, Department of Anesthesiology, Zhejiang Shuren University Shulan International Medical College Affiliated Shulan (Hangzhou) Hospital, No. 848 Dongxin Road, Hangzhou 310000, Zhejiang Province, China. suqin.huang@shulan.com
Received: April 30, 2025
Revised: May 29, 2025
Accepted: June 23, 2025
Published online: August 27, 2025
Processing time: 117 Days and 4.2 Hours
Abstract
BACKGROUND

The use of an ultrasound-guided quadratus lumborum block (QLB) combined with general anesthesia for patients undergoing colorectal cancer surgery serves as a model for reducing the postoperative stress response, preserving metabolic stability, protecting renal function, and alleviating postoperative pain.

AIM

To compare QLB combined with general anesthesia vs general anesthesia alone in the perioperative stress response, metabolic and renal function, postoperative pain, and recovery outcomes among patients undergoing colorectal cancer surgery.

METHODS

Clinical data of 116 patients who underwent colorectal cancer surgery at our hospital between July 2023 and August 2024 were collected for retrospective analysis. According to the anesthesia protocol, the patients were divided into the control (general anesthesia, n = 58) and experimental groups (QLB combined with general anesthesia, n = 58). Physiological indicators such as blood glucose (GLU), lactic acid (LAC), blood urea nitrogen (BUN), and creatinine (CRE) were measured at T0 (pre-surgery), T1 (post-surgery), T2 (6 hours post-surgery), T3 (24 hours post-surgery), and T4 (48 hours post-surgery). The differences between the two groups for each indicator were evaluated using repeated-measures analysis of variance.

RESULTS

The GLU levels from T1 to T4 in the experimental group were significantly lower than those in the control group (P < 0.001), and the LAC levels were also significantly reduced (P < 0.001). The experimental group exhibited superior renal protection based on postoperative BUN and CRE levels (P < 0.05). Furthermore, the postoperative pain score in the experimental group was significantly lower than that in the control group [visual analogue scale (VAS)] scores differed significantly from T2 to T4, P < 0.05.

CONCLUSION

Research has shown that QLB combined with general anesthesia can decrease postoperative GLU and LAC by 8%-15% and 10%-20% (P < 0.001), respectively. It also enhances renal function markers (BUN, CRE, P < 0.05) and lowers VAS scores by 15%-30% (P < 0.05). Ultrasound-guided lumbar muscle block with general anesthesia outperforms general anesthesia alone in diminishing stress response, preserving metabolic balance and renal function, and alleviating postoperative pain. This approach offers a more efficient perioperative management strategy for patients undergoing colorectal cancer surgery. It is particularly advantageous for individuals with stress sensitivity, renal impairment, and heightened pain susceptibility.

Keywords: Quadratus lumborum block; General anesthesia; Colorectal cancer; Perioperative period; Colorectal cancer surgery

Core Tip: This retrospective study demonstrates that ultrasound-guided quadratus lumborum block (QLB) combined with general anesthesia significantly improves perioperative outcomes in colorectal cancer surgery. Compared to general anesthesia alone, QLB reduces stress markers (glucose, lactic acid), enhances renal function (blood urea nitrogen, creatinine), and lowers postoperative pain scores. These findings support the use of QLB as a superior anesthetic strategy to maintain circulatory and metabolic stability, protect organ function, and improve recovery. QLB is especially beneficial for patients with renal vulnerability, high stress reactivity, or low pain tolerance, offering safer and more effective perioperative management.