Abstract / Summary
Abstract Purpose: Opioid analgesics may impair postoperative recovery and prolong hospital stay owing to common adverse effects, including opioid-induced hyperalgesia, postoperative nausea and vomiting, and shivering. This study aimed to evaluate the effects of a multimodal opioid-sparing anesthesia strategy on postoperative quality of recovery , perioperative hemodynamic profiles, and postoperative adverse events in patients undergoing laparoscopic colorectal resection, to further supplement clinical evidence for enhanced postoperative recovery management. Patients and methods: 56 adult patients undergoing laparoscopic colorectal resection were randomly assigned to the multimodal opioid‑sparing anesthesia group (Group OSA) or the conventional opioid‑based anesthesia group (Group OA). The primary outcome was postoperative quality of recovery measured by the QoR‑15 scale on postoperative day 2 (POD 2). Secondary outcomes included QoR‑15 scores on postoperative day 7 (POD 7), visual analogue scale (VAS) pain scores recorded at 2, 4, 8, 24, and 48 hours postoperatively, 24‑hour postoperative sufentanil consumption, intraoperative mean arterial pressure values, and the incidence of perioperative adverse reactions. Results: Patients in Group OSA achieved significantly higher QoR‑15 scores than Group OA at both POD 2 and POD 7: 110.0 (108.0, 111.0) vs. 89.0 (87.0, 91.0); 131.5 (130.0, 135.0) vs. 105.5 (105.0, 108.0), P < 0.001. VAS pain scores were significantly lower in Group OSA at 2, 4, 8 and 24 hours after surgery: 1 (1–2) vs 2 (2–3); 2 (1–2) vs 3 (2–3); 2 (2–3) vs 3 (2–3); 2 (1–2) vs 2 (2–3), P < 0.05. There was a significant difference in 24‑hour postoperative sufentanil consumption and effective pressing times after surgery (77.5 (75.8, 80.0) vs. 65.0 (63.0, 66.0); 2.8 ± 0.5 vs. 2.5 ± 0.5, P＜0.05) (Table 1). Mean arterial pressure (MAP) was significantly higher in Group OSA at pre‑intubation (T1) and 1 min before skin incision (T3): 84.3 ± 3.1 vs 77.4 ± 5.4; 83.0 ± 2.5 vs 80.3 ± 3.6, P < 0.05. Patients in the OSA group also experienced a significantly lower incidence of nausea and vomiting compared to those in the OA group ( P < 0.05). Conclusion: In conclusion, our findings suggest that multimodal opioid‑sparing anesthesia may confer partial, time‑limited benefits in early postoperative recovery quality for patients undergoing laparoscopic colorectal resection. Such benefits were largely driven by higher POD 2 global QoR‑15 scores, whereas several secondary endpoints did not yield significant between‑group differences. Additional investigations are needed to validate these results. Clinical Trial Registry: ChiCTR2400081940；Date: March 15th, 2024