Key result
Preemptive multimodal analgesia significantly reduced the incidence of postoperative gastrointestinal dysfunction compared to postoperative analgesia (13.43% vs 31.82%) in elderly patients undergoing laparoscopic colorectal surgery.
Why the study?
The study was conducted to evaluate the effectiveness of preemptive multimodal analgesia in elderly patients undergoing laparoscopic colorectal surgery.
Does preemptive multimodal analgesia reduce postoperative gastrointestinal dysfunction and delirium in elderly patients undergoing laparoscopic colorectal surgery compared to postoperative analgesia?
RCT (n=133)
Random number table method
No
Does preemptive multimodal analgesia reduce postoperative gastrointestinal dysfunction and delirium in elderly patients undergoing laparoscopic colorectal surgery compared to postoperative analgesia?
Absolute Event Rate: 13.43% vs 31.82%
p-value: p=0.0063
Preemptive multimodal analgesia significantly reduces postoperative gastrointestinal dysfunction, delirium, and pain in elderly patients undergoing laparoscopic colorectal surgery compared to postoperative analgesia.
Supports preemptive multimodal analgesia to lower POGD in elderly laparoscopic colorectal surgery; extends RCT evidence over postoperative-only regimens.
Objective To evaluate the effectiveness of preemptive multimodal analgesiain elderly patients undergoing laparoscopic colorectal surgery. Methods A prospective randomized controlled study was conducted in the Department of Gastrointestinal Surgery of the Second Hospital of Hebei Medical University from January 2022 to December 2022. A total of 133 patients were included according to the criteria and randomly divided into preemptive analgesia (PRA) group (test group, 67patients) and postoperative analgesia (POA) group (control group, 66patients). Results The Visual Analog Scale (VAS)scores of PRA group 24 h, 48 h, and 72 h after operation were lower than those of POA group, and the difference was statistically significant, P < 0.001.The incidences of postoperative gastrointestinal dysfunction (POGD) and postoperative delirium (POD)in PRA group were 13.43% and 8.98%, respectively, which were significantly lower than those in POA group (31.82% and 24.24%), P < 0.05. The levels of IL-6 and IL-10 in PRA group after the operation were 17.54 ± 2.13 ng/L and 15.57 ± 1.71 ng/L respectively, which were lower than those in POA group (25.45 ± 2.95 ng/L and 23.45 ± 1.88 ng/L), P < 0.05. The level of acetylcholinesterase(AchE) was 56.34 ± 5.62 nmol/L in the POA group, which was significantly higher than that in the POA group (49.59 ± 5.52 nmol/L), P < 0.001. Conclusion Preemptive multimodal analgesia can reduce the incidence of POGD and POD in elderly patients undergoing laparoscopic gastrocolic surgery, improve the recovery process of postoperative gastrointestinal function, increase the concentrations of propionic acid and butyric acid in short chain fatty acids (SCFAs) and the number of beneficial intestinal bacteria.
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Sun et al. (2024) conducted an RCT in Colorectal cancer (n=133). Preemptive multimodal analgesia vs. Postoperative multimodal analgesia was evaluated on Incidence of postoperative gastrointestinal dysfunction (POGD) assessed by I-FEED score ≥ 6 (p=0.0063). Preemptive multimodal analgesia significantly reduced the incidence of postoperative gastrointestinal dysfunction compared to postoperative analgesia (13.43% vs 31.82%) in elderly patients undergoing laparoscopic colorectal surgery.
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