Effect of multimodal preemptive analgesia on postoperative gastrointestinal function and clinical outcome in patients undergoing laparoscopic colorectal surgery. Issue 12 (10th October 2021)

• Record Type: Journal Article
• Authors: Liu, Chaolei; Wang, Tianlong; Kang, Rongtian; Huang, Lingning; Sun, Zhangnan
• Is Part Of: International journal of clinical practice. Volume 75:Issue 12(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-10-10
• Subjects: Clinical medicine -- Periodicals; Medicine -- Periodicals; 610.5
• DOI: 10.1111/ijcp.14881
• Languages: English
• ISSNs: 1368-5031

Abstract

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.