Published online Jun 27, 2025. doi: 10.4240/wjgs.v17.i6.102907
Revised: March 24, 2025
Accepted: April 24, 2025
Published online: June 27, 2025
Processing time: 101 Days and 3 Hours
The dexmedetomidine (DEX) plus ropivacaine treatment enables a transversus abdominis plane block (TAPB) of the peripheral nerves in patients undergoing radical resection for colorectal cancer (CRC) that can provide clinical data for improving the postoperative analgesic effect, reducing the risk of cognitive impairment, and decreasing the circulating levels of serum inflammatory factors and stress hormones.
To assess the impact of DEX plus ropivacaine-enabled TAPB on pain, postope
Our patient cohort was randomly divided into control and observation groups (60/group). The observation group used a DEX plus ropivacaine-enabled TAPB, while the control group employed a ropivacaine-enabled TAPB. The pain score [Visual Analogy Scale (VAS), Montreal Cognitive Assessment (MoCA)], serum inflammatory factor level (C-reactive protein, interleukin-6 and tumor necrosis factor-α), serum stress hormone levels (cortisol and adrenaline) and postoperative adverse reactions were compared between the two groups.
The observation group VAS scores were lower than those of the control group (better analgesic effect, P < 0.05). The MoCA and POCD scores decreased post-surgery in the observation group (P < 0.05). In the elderly, the overall VAS and MoCA scores were significantly reduced compared with the young group. The C-reactive protein, interleukin-6, tumor necrosis factor-α, cortisol and adrenaline levels were lower in the observation group compared with the control group post-surgery (P < 0.05). There was no significant difference in adverse reactions between the two groups post-surgery, but the incidence of adverse reactions in the observation group was still lower. DEX continuously inhibited p65-phosphorylation levels in the nuclear factor κB pathway at multiple time points, and its inhibitory effect became more significant over time.
DEX plus ropivacaine-enabled TAPB reduces POCD and inflammatory/stress hormone levels, and significantly improves the postoperative analgesic effect of patients undergoing radical resection for colorectal cancer.
Core Tip: The dexmedetomidine plus ropivacaine combination for transversus abdominis plane block significantly improves postoperative outcomes in patients undergoing radical resection for colorectal cancer. This treatment enhances pain control, reduces postoperative cognitive dysfunction, and lowers the levels of serum inflammatory markers and stress hormones, such as cortisol and adrenaline. The approach provides a promising strategy for better managing postoperative analgesia and minimizing cognitive decline, particularly in elderly patients. Moreover, it demonstrates a favorable safety profile with fewer adverse reactions compared to traditional analgesic methods, making it a valuable addition to colorectal surgery protocols.