Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Dec 15, 2023; 15(12): 2101-2110
Published online Dec 15, 2023. doi: 10.4251/wjgo.v15.i12.2101
Application of remimazolam transversus abdominis plane block in gastrointestinal tumor surgery
Jun Liu, Jian-Min Tian, Guo-Ze Liu, Jun-Na Sun, Peng-Fei Gao, Yong-Qiang Zhang, Xiu-Qin Yue
Jun Liu, Jian-Min Tian, Guo-Ze Liu, Jun-Na Sun, Peng-Fei Gao, Yong-Qiang Zhang, Xiu-Qin Yue, Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, Henan Province, China
Author contributions: Liu J, Tian JM, and Liu GZ initiated the project, Tian JM and Sun JN designed the experiment and conducted clinical data collection; Liu GZ and Gao PF performed postoperative follow-up and recorded data; Liu J, Sun JN, and Gao PF conducted a number of collation and statistical analysis, and wrote the original manuscript; Liu J, Zhang YQ and Yue XQ reviewed and approved the paper; all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board at First Affiliated Hospital of Xinxiang Medical University.
Informed consent statement: As the study used anonymous and pre-existing data, the requirement for the informed consent from patients was waived.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Liu, MM, Doctor, Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Xinxiang Medical University, No. 88 Jiankang Road, Weihui 453100, Henan Province, China. t604au@126.com
Received: September 21, 2023
Peer-review started: September 21, 2023
First decision: October 9, 2023
Revised: October 26, 2023
Accepted: November 25, 2023
Article in press: November 25, 2023
Published online: December 15, 2023
Processing time: 83 Days and 19.6 Hours
Abstract
BACKGROUND

Transversus abdominis plane block (TAPB) is a block of the abdominal afferent nerve fibers between the internal oblique muscle and the transverse abdominal muscle achieved with local anesthetics. It can effectively block the conduction of the anterior nerve of the abdominal wall and exert a good analgesic effect. However, the effect of combining the block with remimazolam on anesthesia in patients undergoing gastrointestinal tumor surgery is still unclear.

AIM

To examine the effects of combining TAPB with remimazolam on the stress response and postoperative recovery of gastrointestinal tumor surgery patients.

METHODS

A retrospective analysis was conducted on the clinical data of 102 individuals diagnosed with gastrointestinal malignancies who underwent laparoscopic surgery under general anesthesia between April 2020 and June 2023. The patients were categorized into a control group (n = 51), receiving remimazolam for general anesthesia, and an observation group (n = 51), receiving TAPB combined with remimazolam for general anesthesia. A comparison was made between both groups in terms of hemodynamic parameters, stress markers, pain levels, recovery quality, analgesic effects, and adverse reactions during the perioperative period.

RESULTS

The observation group had significantly higher heart rates at time points 1 min after induction and upon leaving the operating room than the control group (P < 0.05). The mean arterial pressure at time point T1 in the observation group was significantly higher than that in the control group (P < 0.05). Five minutes after extubation, the levels of the hormones adrenaline and noradrenaline in the observation group were considerably lower than those in the control group (P < 0.05). At 12 h, 24 h, and 48 h following surgery, the visual analog scale scores of the observation group were considerably lower than those of the control group (P < 0.05). The observation group had shorter awakening and extubation times and lower Riker sedation-agitation scale scores than the control group (P < 0.05). The observation group exhibited considerably fewer effective pump presses, lower fentanyl dosages, and lower incidences of rescue analgesia within 24 h following surgery than the control group (P < 0.05).

CONCLUSION

The application effect of TAPB combined with remimazolam general anesthesia in anesthesia of patients undergoing gastrointestinal tumor surgery is good, which is helpful to promote faster recovery after operation.

Keywords: Transversus abdominis plane block; Remimazolam; General anesthesia; Gastrointestinal tumor surgery; Stress response

Core Tip: Stress can lead to severe changes in hemodynamics during surgery and increase the risk of postoperative adverse events. In this study, the application value of transversus abdominis plane block (TAPB) combined with remimazolam general anesthesia in patients undergoing gastrointestinal tumor surgery was observed. The results showed that the application of TAPB combined with remimazolam general anesthesia had the advantages of stable anesthesia induction and small hemodynamic fluctuation, which was helpful to reduce the acute stress response of patients undergoing gastrointestinal tumor surgery and improve the quality of recovery.