Effect of quadratus lumborum block combined with butorphanol-based PCIA on postoperative analgesia and early recovery in patients undergoing colorectal cancer surgery.

OBJECTIVE: To explore the impact of quadratus lumborum block (QLB) combined with butorphanol-based patient-controlled intravenous analgesia (PCIA) on intraoperative opioid use, postoperative analgesia, and recovery indicators in patients undergoing colorectal tumor surgery. METHODS: A retrospective analysis was conducted on 78 patients who underwent radical resection of colorectal tumors. Based on postoperative analgesia strategies, patients were divided into two groups: the QLB combined with butorphanol PCIA group (QB group, n = 38) and the butorphanol PCIA group (B group, n = 40). Parameters compared between groups included intraoperative sufentanil consumption, postoperative Visual Analog Scale (VAS) scores, hemodynamic and respiratory indicators, recovery time, Mini-Cognitive Evaluation Scale (MESS) scores, incidence of adverse reactions, and lower limb motor function. RESULTS: The QB group had significantly lower total and hourly intraoperative sufentanil consumption than the B group (P = 0.014). VAS scores were significantly lower in the QB group from 30 minutes to 6 hours postoperatively (P < 0.05). Additionally, the QB group showed more stable intraoperative heart rate (HR) and mean arterial pressure (MAP), along with higher partial pressure of end-tidal carbon dioxide (PETCO2) levels. Cognitive function, as measured by MESS scores at 24, 48, and 72 hours postoperatively, was significantly better in the QB group (P < 0.05). However, the B group experienced shorter times to orientation recovery, extubation, spontaneous breathing, and overall awakening. Lower limb muscle strength scores were comparable between groups, with no observed impairments in ambulation. The overall incidence of adverse reactions did not differ significantly between groups (QB group: 5.26% vs. B group: 7.5%; P > 0.05). CONCLUSION: QLB combined with butorphanol-based PCIA effectively enhances early postoperative analgesia and promotes hemodynamic and respiratory stability in patients undergoing colorectal tumor surgery, supporting its broader application for postoperative analgesia in this patient population.