Perioperative Observation Of Laparoscopic Assisted Colorectal Tumor Resection With Opioid-free Anesthesia Combined With Bilateral Paravertebral Nerve Block

Objective: As the most classic narcotic analgesics,opioid overdose and long-term use are important factors leading to postoperative complications and poor prognosis.The 2018 surgical guidelines for accelerated recovery in colorectal surgery recommend low-dose opioid anesthesia with perioperative that is general anesthesia combined with regional or local anesthesia.Meanwhile,opioid-free anesthesia has been successfully used in radical mastectomy and laparoscopic cholecystectomy,but its indications and advantages and disadvantages are still controversial.In this study,to observe the overall quality and postoperative functional recovery in patients undergoing laparoscopic-assisted colorectal tumor resection with opioid-free anesthesia combined with bilateral paravertebral nerve block during the perioperative period,so as to provide a reference for clinical application.Methods: 119 patients who underwent selective laparoscopic colorectal tumor resection in our hospital from February to November 2019 were randomly divided into the low-dose Opioid Anaesthesia(OA)group and the Opioid Free Anaesthesia(OFA)group.Record the data of depth of anesthesia,hemodynamics,arterial blood gas,and time of extubation,and collect the postoperative pain information of the patients,including Visual Analogue Scale(VAS),exhaust time,feeding time,time of getting out of bed,postoperative length of stay and total cost.The differences between the two groups were compared.Results: 1.There were no significant differences in gender,age and body mass index between the two groups.2.There was no statistical difference in intraoperative heart rate(HR)between the two groups(P> 0.05),but the mean arterial pressure(MAP)of the OFA group was more stable than that of the OA group.3.Intraoperative blood glucose was significantly increased in OFA group(P< 0.05).4.There was no significant difference in intraoperative vasoactive drug dosage,infusion volume,urine volume,blood loss,blood transfusion volume and operation time between the two groups(P> 0.05).The extubation time of OFA group was significantly longer than that of OA group,and the difference was statistically significant(P< 0.05).5.There was no significant difference in VAS scores(rest and exercise)for three consecutive days after surgery between the two groups,and the dosage of analgesic drugs in OFA group was lower than OA group for three consecutive days after surgery,and the difference was statistically significant(P<0.05).6.There was no significant difference in postoperative exhaust time,drinking water time,postoperative hospitalization time and total hospitalization cost between the two groups(P>0.05).Conclusion: Opioid-free anesthesia can be safely and effectively used in laparoscopic colorectal tumor resection.Compared with low-dose opioid anesthesia,opioid-free anesthesia has more stable hemodynamics in the recovery period,less postoperative demand for analgesics,and more advantages in overall analgesia.There was no significant difference in functional recovery between the two methods.