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Retrospective Cohort Study
Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Oncol. Aug 15, 2026; 18(8): 120096
Published online Aug 15, 2026. doi: 10.4251/wjgo.v18.i8.120096
Effects of general anesthesia plus ropivacaine transversus abdominis plane block on analgesia and organ protection in colorectal cancer surgery
Wan-Min Pei, Yan Ye, Jian Liu, Hui-Ling Tan, Yi-Xun Tang, Ji-Tong Liu
Wan-Min Pei, Yan Ye, Jian Liu, Hui-Ling Tan, Yi-Xun Tang, Ji-Tong Liu, Department of Anesthesiology, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha 410005, Hunan Province, China
Author contributions: Pei WM and Liu JT contributed to conceptualization; Pei WM, Ye Y, Liu J, Tan HL, and Tang YX contributed to data curation; Pei WM and Ye Y contributed to formal analysis; Pei WM contributed to writing - original draft; Ye Y contributed to visualization; Ye Y, Tang YX, and Liu JT contributed to writing - review & editing; Liu J and Tan HL contributed to validation; Liu J and Tang YX contributed to investigation; Tan HL contributed to resources; Liu JT contributed to project administration, supervision, final approval of the manuscript. All authors have read and agreed to the published version of the manuscript.
AI contribution statement: To ensure the accuracy of the language, we used AI tools to check for grammar errors and make corrections in answering reviewers, but the content was not generated by AI.
Institutional review board statement: This study was approved by the Ethics Committee of Hunan Provincial People’s Hospital (No. 2026-028).
Informed consent statement: This study is a retrospective study and has applied for an exemption from the informed consent form procedure.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The data can be obtained by contacting the corresponding author.
Corresponding author: Ji-Tong Liu, PhD, Department of Anesthesiology, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), No. 61 Jiefang West Road, Furong District, Changsha 410005, Hunan Province, China. liujitong999@163.com
Received: March 6, 2026
Revised: April 20, 2026
Accepted: May 26, 2026
Published online: August 15, 2026
Processing time: 150 Days and 6.9 Hours
Abstract
BACKGROUND

The global incidence of colorectal cancer (CRC) is rising annually, with radical resection as its primary curative treatment. Conventional general anesthesia for CRC surgery is frequently complicated by inadequate postoperative analgesia and opioid-related adverse reactions. Although ropivacaine transversus abdominis plane block (TAPB) is a widely used multimodal analgesic technique, its comprehensive effects on perioperative inflammatory stress and organ function in CRC patients remain insufficiently investigated.

AIM

To investigate the effects of general anesthesia + ropivacaine TAPB in patients undergoing radical resection for CRC.

METHODS

This retrospective cohort study analyzed clinical data of patients who underwent radical resection for CRC at Hunan Provincial People’s Hospital between December 2018 and January 2025. Patients who received general anesthesia alone were assigned to the control group, and those who received general anesthesia plus ropivacaine TAPB were assigned to the combination group. Postoperative recovery indices, resting and postoperative state visual analog scale (VAS) scores, and pre- and postoperative inflammatory and liver/kidney function indices were extracted. The incidence of postoperative complications was assessed. Multiple linear regression analysis was performed to identify factors influencing postoperative pain.

RESULTS

Overall, 208 patients were evaluated (control group, n = 85; combination group, n = 123). The combination group experienced shorter times to first flatus, resumption of regular eating, and first defecation, and shorter postoperative hospital stay, and lower VAS scores at 6 hours, 24 hours, and 48 hours postoperatively than controls (all P < 0.05). Compared with controls, the combination group showed lower levels of interleukin-6, white blood cell count, and serum lactate at 24 hours postoperatively (all P < 0.05), and lower levels of alanine aminotransferase, aspartate aminotransferase, serum creatinine, and blood urea nitrogen at 72 hours postoperatively (all P < 0.05). The overall complication rate did not differ (P = 0.150); however, a lower incidence of postoperative nausea and vomiting was observed in the combination group (P = 0.032). Multiple linear regression analysis identified anesthesia regimen (β = -0.816, P < 0.001) and body mass index (β = 0.040, P = 0.024) as independent influencing factors of the VAS score at 24-hour postoperatively.

CONCLUSION

General anesthesia + ropivacaine TAPB for radical resection of CRC provides superior postoperative analgesic effects, effectively reduces inflammatory and stress responses, and is associated with lower postoperative liver and kidney function indices.

Keywords: General anesthesia; Transversus abdominis plane block; Ropivacaine; Radical resection of colorectal cancer; Postoperative analgesia; Inflammatory response

Core Tip: This retrospective study demonstrated that, for patients undergoing radical resection of colorectal cancer, general anesthesia combined with ropivacaine transversus abdominis plane block provides superior postoperative analgesia, reduces inflammatory stress, is associated with favorable postoperative liver and kidney function indices, and accelerates early recovery compared with general anesthesia alone.

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