Ultrasound-guided quadratus lumborum block with general anesthesia for perioperative circulatory stability in colorectal cancer surgery.

Abstract

Background: The use of an ultrasound-guided quadratus lumborum block (QLB) combined with general anesthesia for patients undergoing colorectal cancer surgery serves as a model for reducing the postoperative stress response, preserving metabolic stability, protecting renal function, and alleviating postoperative pain.

Aim: To compare QLB combined with general anesthesia vs general anesthesia alone in the perioperative stress response, metabolic and renal function, postoperative pain, and recovery outcomes among patients undergoing colorectal cancer surgery.

Methods: Clinical data of 116 patients who underwent colorectal cancer surgery at our hospital between July 2023 and August 2024 were collected for retrospective analysis. According to the anesthesia protocol, the patients were divided into the control (general anesthesia, n = 58) and experimental groups (QLB combined with general anesthesia, n = 58). Physiological indicators such as blood glucose (GLU), lactic acid (LAC), blood urea nitrogen (BUN), and creatinine (CRE) were measured at T0 (pre-surgery), T1 (post-surgery), T2 (6 hours post-surgery), T3 (24 hours post-surgery), and T4 (48 hours post-surgery). The differences between the two groups for each indicator were evaluated using repeated-measures analysis of variance.

Results: The GLU levels from T1 to T4 in the experimental group were significantly lower than those in the control group (P < 0.001), and the LAC levels were also significantly reduced (P < 0.001). The experimental group exhibited superior renal protection based on postoperative BUN and CRE levels (P < 0.05). Furthermore, the postoperative pain score in the experimental group was significantly lower than that in the control group [visual analogue scale (VAS)] scores differed significantly from T2 to T4, P < 0.05.

Conclusion: Research has shown that QLB combined with general anesthesia can decrease postoperative GLU and LAC by 8%-15% and 10%-20% (P < 0.001), respectively. It also enhances renal function markers (BUN, CRE, P < 0.05) and lowers VAS scores by 15%-30% (P < 0.05). Ultrasound-guided lumbar muscle block with general anesthesia outperforms general anesthesia alone in diminishing stress response, preserving metabolic balance and renal function, and alleviating postoperative pain. This approach offers a more efficient perioperative management strategy for patients undergoing colorectal cancer surgery. It is particularly advantageous for individuals with stress sensitivity, renal impairment, and heightened pain susceptibility.