Published online Dec 15, 2023. doi: 10.4251/wjgo.v15.i12.2101
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
Carbon dioxide pneumoperitoneum will be established in patients with gastrointestinal tumors during laparoscopic surgery, resulting in intra-abdominal hypertension, which is easy to cause stress response. At the same time, the change of posture will also aggravate the stress response, which will seriously affect the effect of surgical treatment and postoperative rehabilitation. Therefore, it is of great significance to adopt a reasonable anesthesia method to promote the postoperative recovery of patients. Transversus abdominis plane block (TAPB) can effectively block the conduction of the anterior nerve of the abdominal wall, resulting in analgesic effect. The success rate of remifentanil analgesia is similar to that of propofol, and the safety is significantly better than that of propofol. It can be used in the induction and maintenance of general anesthesia. The combination of TAPB and remimazolam and remimazolam can provide a basis for the anesthetic regimen to reduce the stress response of laparoscopic patients with gastrointestinal tumors.
The use of different anesthetics during the perioperative period of gastrointestinal tumors has an important impact on the stress response caused by general anesthesia. In the past, propofol was mostly used, but its obvious inhibition of circulatory and respiratory function can easily lead to intraoperative hemodynamic fluctuations. In addition, the change of intraoperative position can easily lead to stress response in patients, causing severe postoperative pain, which has a serious impact on the surgical effect and postoperative recovery. Remimazolam has the advantages of fast metabolism, no residue and little influence on respiration and circulation. However, the analgesic and sedative effects of simple application of remifentanil general anesthesia are similar to those of propofol. Therefore, it is necessary to combine the application of TAPB on the basis of remifentanil general anesthesia to improve the analgesic effect. It is expected to become an important anesthetic and analgesic scheme for laparoscopic surgery of gastrointestinal tumors in the future.
This study mainly discussed the effect of TAPB combined with remimazolam general anesthesia on stress response and postoperative recovery in patients undergoing gastrointestinal tumor surgery. The results showed that the application of TAPB combined with remimazolam general anesthesia in gastrointestinal tumor surgery had the advantages of stable anesthesia induction, small hemodynamic fluctuation, low incidence of cardiovascular events, fast postoperative recovery and less agitation. It is helpful to reduce acute stress response, improve the quality of recovery, and the level of analgesia and sedation can meet the needs of surgery. In the future, it can be used as an anesthesia and analgesia program for patients undergoing laparoscopic surgery for gastrointestinal tumors.
In this study, the clinical data of patients with gastrointestinal tumors who underwent laparoscopic surgery under general anesthesia were retrospectively analyzed. The patients were grouped according to different anesthesia schemes, and the hemodynamics, stress response and recovery quality of the observation group and the control group were compared. The data were analyzed by SPSS22.0 software to further clarify the application value of TAPB combined with remimazolam general anesthesia in patients undergoing gastrointestinal tumor surgery.
This study further clarified that TAPB combined with remimazolam general anesthesia can effectively alleviate the stress response of patients undergoing gastrointestinal tumor surgery. The level of analgesia and sedation is good, the intraoperative hemodynamic fluctuation is small, and the quality of recovery is good. However, this study is a retrospective analysis, and it is impossible to analyze the long-term effects of this anesthesia program and its application effect in other operations. In the future, the sample size will be further expanded to explore the application value of this anesthesia program.
The application of TAPB combined with remifentanil general anesthesia in gastrointestinal tumor surgery has the advantages of stable anesthesia induction, small hemodynamic fluctuations, low incidence of cardiovascular events, rapid postoperative recovery and less agitation. It is helpful to reduce acute stress response, improve the quality of recovery, and the level of analgesia and sedation can meet the needs of surgery.
In the future, the sample size will be expanded to explore the application value of TAPB combined with remifentanil general anesthesia in other types of laparoscopic surgery anesthesia.