Journal of Shandong University (Health Sciences) ›› 2019, Vol. 57 ›› Issue (9): 38-42.doi: 10.6040/j.issn.1671-7554.0.2019.286

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Effects of multimodal analgesia under the guidance of enhanced recovery after open surgery on postoperative recovery of patients with colon cancer

ZHOU Jiahui1, WANG Gang2, LIU Jiang2, ZHAO Jian3, WANG Haifeng3, JIANG Zhiwei1,2,3   

  1. 1. Jinling Hospital, Nanjing Medical University, Nanjing 210002, Jiangsu, China;
    2. Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210029, Jiangsu, China;
    3.Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu, China
  • Published:2022-09-27

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Abstract: Objective To investigate the effects of multimodal analgesia(MMA)on postoperative recovery in patients undergoing open colon cancer surgery under the guidance of enhanced recovery after surgery(ERAS). Methods The clinical data of 62 patients from Jinling Hospital, Medical School of Nanjing University who underwent open colon cancer surgery during Jul. and Nov. 2018 were retrospective analyzed. The patients were divided into two groups: multimodal analgesia group(MMA group, n=31)and the patient-controlled intravenous analgesia group(PCIA group, n=31). The visual analogue score(VAS), recovery and incidence of complications 30 days after surgery were observed and compared between the two groups. Results Compared with the PCIA group, the MMA group needed shorter time for the first flatus ［(28.1±15.2)h vs(50.2±26.2)h,t=4.059,P<0.001］, first defecation［(38.9±19.4)h vs(62.6±25.8 h,t=4.085,P<0.001］, first off-bed activity［(17.6±9.3)h vs(30.0±13.4)h,t=4.259,<0.001］, first semi-liquid meal［(21.3±9.5)h vs(60.6±27.0)h,t=7.652,P<0.001］, and shorter postoperative stay ［(6.8±4.7)d vs(8.8±1.9)d, 山 东 大 学 学 报 (医 学 版)57卷9期 -周嘉晖,等.加速康复外科指导下的多模式镇痛对开腹结肠癌患者术后恢复的影响 \=-t=2.150,P=0.036］. The MMA group had better analgesia effect than the PCIA group, but there was no significant difference in the incidence of complications between the two groups 30 days after surgery. Conclusion Under the guidance of ERAS, multimodal analgesia can help the patients recovery. It is safe and effective, without increasing the risk of postoperative complications.

Key words: Multimodal analgesia, Colon cancer, Enhanced recovery after surgery, Postoperative recovery

CLC Number: 

  • R619
[1] 王锡山. 中美结直肠癌流行病学特征及防诊治策略的对比分析[J]. 中华结直肠疾病电子杂志, 2017, 6(6): 447-453.
[2] Kehlet H, Wilmore D. Evidence-based surgical care and the evolution of fast-track surgery [J]. Ann Surg, 2008, 248(2): 189-198.
[3] 陈凛, 陈亚进, 董海龙, 等. 加速康复外科中国专家共识及路径管理指南(2018版)[J]. 中国实用外科杂志, 2018, 38(1): 1-20.
[4] Sullivan D, Lyons M, Montgomery R, et al. Exploring opioid-sparing multimodal analgesia options in trauma: a nursing perspective [J]. J Trauma Nurs, 2016, 23(6): 361-375.
[5] Joshi GP, Bonnet F, Kehlet H. Evidence-based postoperative pain management after laparoscopic colorectal surgery [J]. Colorectal Dis, 2013, 15(2):146-155.
[6] 中华人民共和国卫生和计划生育委员会医政医管局. 中国结直肠癌诊疗规范(2015版)[J]. 中华消化外科杂志, 2015, 14(6): 783-799.
[7] Hawker GA, Mian S, Kendzerska T, et al. Measures of adult pain: visual analog scale for pain(VAS Pain), numeric rating scale for pain(NRS Pain), mcgill pain questionnaire(MPQ), short-form mcgill pain questionnaire(SF-MPQ), chronic pain grade scale(CPGS), short form-36 bodily pain scale(SF-36 BPS), and Measure of intermittent and constant osteoarthritis pain(ICOAP)[J]. Arthritis Care Res(Hoboken), 2011, 63(Suppl 11): S240-252. doi: 10.1002/acr.20543.
[8] Gordon DB, de Leon-Casasola OA, Wu CL, et al. Research gaps in practice guidelines for acute postoperative pain management in adults: findings from a review of the evidence for an american pain society clinical practice guideline [J]. J Pain, 2016, 17(2): 158-166.
[9] Jarzyna D, Jungquist CR, Pasero C, et al. American society for pain management nursing guidelines on monitoring for opioid-Induced sedation and respiratory depression [J]. Pain Manag Nurs, 2011, 12(3): 118-145.
[10] Beverly A, Kaye AD, Ljungqvist O, et al. Essential elements of multimodal analgesia in enhanced recovery after surgery(ERAS)guidelines [J]. Anesthesiol Clin, 2017, 35(2): e115-e143. doi: 10.1016/j.anclin.2017.01.018.
[11] Woolf CJ, American College of Physicians,American Physiological Society. Pain: moving from symptom control toward mechanism-specific pharmacologic management [J]. Ann Intern Med, 2004, 140(6): 441-451.
[12] 戴仁锋, 王伟娟, 刘英. 罗哌卡因局部浸润对全身麻醉下扁桃体摘除术后小儿躁动的影响[J]. 中华全科医学, 2016, 14(5): 736-738.
[13] Hofstad JK, Winther SB, Rian T, et al. Perioperative local infiltration anesthesia with ropivacaine has no effect on postoperative pain after total hip arthroplasty [J]. Acta Orthop, 2015, 86(6): 654-658.
[14] Bekhit MH. Profile of extended-release oxycodone/acetaminophen for acute pain [J]. J Pain Res, 2015, 8: 719-728. doi: 10.2147/JPR.S73567.
[15] 刘艳君, 王鸾, 张文, 等. 氨酚羟考酮与盐酸曲马多在混合痔术后镇痛中的效果对比观察[J]. 中国临床医生杂志, 2018, 46(2):211-212.
[16] 崔向丽, 赵志刚, 陈丽, 等. 新型注射用选择性COX-2抑制剂帕瑞昔布钠[J]. 中国新药杂志, 2009, 18(14): 1283-1286.
[17] Essex MN, Xu H, Parsons B, et al. Parecoxib relieves pain and has an opioid-sparing effect following major gastrointestinal surgery [J]. Int J Gen Med, 2017, 10: 319-327. doi: 10.2147/IJGM.S143837.
[18] Klein M. Postoperative non-steroidal anti-inflammatory drugs and colorectal anastomotic leakage. NSAIDs and anastomotic leakage [J]. Dan Med J, 2012, 59(3): B4420.
[19] Huang Y, Tang SR, Young CJ. Nonsteroidal anti-inflammatory drugs and anastomotic dehiscence after colorectal surgery: a meta-analysis [J]. ANZ J Surg, 2018, 88(10): 959-965.
[20] Bruhn J, Scheffer GJ, van Geffen GJ. Clinical application of perioperative multimodal analgesia [J]. Curr Opin Support Palliat Care, 2017, 11(2): 106-111.
[21] De Oliveira GS, Almeida MD, Benzon HT, et al. Perioperative single dose systemic dexamethasone for postoperative pain: a meta-analysis of randomized controlled trials [J]. Anesthesiology, 2011, 115(3): 575-588.
[22] Kassim DY, Esmat IM, Elgendy MA. Impact of duloxetine and dexamethasone for improving postoperative pain after laparoscopic gynecological surgeries: A randomized clinical trial [J]. Saudi J Anaesth, 2018, 12(1): 95-102.
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