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无阿片类麻醉用于腹腔镜辅助结直肠肿瘤切除术后短期恢复的疗效:一项随机试验

Efficacy of opioid-free anesthesia in short-term recovery following laparoscopic-assisted colorectal tumor resection: a randomized trial.

作者信息

Zhang Liang, Yu Xian-Hua, Zhang Hui-Ming, Wang Sheng, Chen Jian-Long, Li Xue-Shan, Chen Zhi-Yuan

机构信息

Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.

Department of Anesthesiology, Sanming First Hospital Affiliated to Fujian Medical University, Sanming, China.

出版信息

Front Oncol. 2025 Jul 2;15:1588623. doi: 10.3389/fonc.2025.1588623. eCollection 2025.

Abstract

OBJECTIVE

This study aims to evaluate whether opioid-free anesthesia is non-inferior to opioid-based anesthesia in terms of short-term recovery quality in patients undergoing laparoscopic-assisted colorectal tumor resection.

METHODS

A randomized controlled trial was conducted with 102 participants, who were randomly assigned to one of two groups: opioid-free general anesthesia with thoracic epidural anesthesia (OFA) group and opioid-based general anesthesia with compound transversalis fascia nerve block (OA) group. The primary observation outcomes were the preoperative and postoperative Quality of Recovery-40 (QoR-40) questionnaire scores.

RESULTS

No statistically significant differences were observed in preoperative or postoperative QoR-40 scores between the two groups ( = 0.05). However, the OFA group demonstrated a significantly longer recovery time in the recovery room compared to the OA group (< 0.05). No significant differences were observed between the two groups in postoperative nausea and vomiting, time to first meal after surgery, postoperative drainage tube removal time, postoperative sufentanil dose, or postoperative 24-hour numerical rating scale ( > 0.05).

CONCLUSION

Opioid-free general anesthesia is not superior to opioid-based general anesthesia with transversalis fascia nerve block in terms of short-term postoperative recovery quality following laparoscopic-assisted colorectal tumor resection.

CLINICAL TRIAL REGISTRATION

https://www.chictr.org.cn/, identifier 2023-12-08.

摘要

目的

本研究旨在评估在接受腹腔镜辅助结直肠肿瘤切除术的患者中,无阿片类药物麻醉在短期恢复质量方面是否不劣于基于阿片类药物的麻醉。

方法

进行了一项随机对照试验,102名参与者被随机分配到两组之一:胸段硬膜外麻醉下的无阿片类药物全身麻醉(OFA)组和复合腹横筋膜神经阻滞下的基于阿片类药物的全身麻醉(OA)组。主要观察指标为术前和术后恢复质量-40(QoR-40)问卷评分。

结果

两组术前或术后QoR-40评分均未观察到统计学显著差异( = 0.05)。然而,与OA组相比,OFA组在恢复室的恢复时间明显更长(< 0.05)。两组在术后恶心呕吐、术后首次进食时间、术后引流管拔除时间、术后舒芬太尼剂量或术后24小时数字评定量表方面均未观察到显著差异( > 0.05)。

结论

在腹腔镜辅助结直肠肿瘤切除术后的短期恢复质量方面,无阿片类药物全身麻醉并不优于复合腹横筋膜神经阻滞的基于阿片类药物的全身麻醉。

临床试验注册

https://www.chictr.org.cn/,标识符2023-12-08。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c28/12263370/5c6b132279e8/fonc-15-1588623-g001.jpg

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