Research Progress of Multimodal Analgesia in Postoperative Analgesia of Elderly Patients After Laparoscopic Gastric Cancer Surgery

Li Liu; Dan Zhou

doi:doi:10.11648/j.ijacm.20261401.21

Review Article |

| Peer-Reviewed

Research Progress of Multimodal Analgesia in Postoperative Analgesia of Elderly Patients After Laparoscopic Gastric Cancer Surgery

Li Liu

, Dan Zhou^*

Published in International Journal of Anesthesia and Clinical Medicine (Volume 14, Issue 1)

Received: 8 March 2026 Accepted: 17 March 2026 Published: 27 March 2026

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Abstract

Postoperative pain is a major clinical challenge for surgical patients, often leading to adverse physiological and psychological events such as hypertension, myocaial ischemia, gastrointestinal dysfunction, delirium, and sleep disorders. Effective postoperative analgesia is crucial as it mitigates excessive stress responses, thereby playing a key role in ensutient safety and promoting recovery. Traditional analgesic methods often rely heavily on single-drug regimens, particularly opioids, which are associated with a high incidence of severe adverse effects such asy depression, nausea, vomiting, and constipation. In response, multimodal analgesia has emerged as a superior paradigm. This strategy integrates drugs and regional techniques with different mechanisf action—for example, combining nonsteroidal anti-inflammatory drugs (NSAIDs), local anesthetics, and adjuvant drugs—to achieve synergistic analgesic effects while minimizine dosage and side effects of individual components. With the rapid development of Enhanced Recovery After Surgery (ERAS) concepts, the advantages of multimodal analgesia have become increasingly promechnological advancements, such as ultrasound-guided nerve blocks and advanced patient-controlled analgesia pumps, have made these regimens more refined and individualized. As a cornerstone of EAS pathways, multimodal analgesia effectively controls pain, significantly reduces opioid-related complications, promotes early mobilization and functional recovery, and shortens length of stay, thereby utilizing medical resources moreefficiently. This study reviews various strategies for postoperative pain management in patients undergoing laparoscopic radical gastrectomy for gastric cancer.

Published in	International Journal of Anesthesia and Clinical Medicine (Volume 14, Issue 1)
DOI	10.11648/j.ijacm.20261401.21
Page(s)	65-72
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

Elderly Patients, Postoperative Analgesia, Multimodal Analgesia, Laparoscopic Radical Gastrectomy for Gastric Cancer

1. Introduction

As China's aging population continues to grow, the proportion of elderly patients undergoing surgical procedures has markedly increased

[1]

. These patients frequently experience organ function degeneration, diminished physical capabilities, and reduced reserve capacity in vital organs, which heightens their surgical risks. In the realm of gastric cancer treatment, laparoscopic gastric cancer resection has emerged as a widely adopted surgical technique, primarily due to its minimally invasive benefits

[2]

. Nevertheless, this procedure still inflicts considerable trauma to the abdominal cavity and necessitates digestive tract reconstruction, leading to significant incision pain, visceral pain, and inflammatory pain postoperatively, which can severely impede patient recovery. Consequently, the establishment of an effective postoperative analgesia protocol with minimal adverse effects is crucial for facilitating the early recovery of these patients. This article seeks to review the commonly employed analgesic methods for elderly patients following laparoscopic radical gastrectomy for gastric cancer.

2. Common Drugs for Multimodal Analgesia

2.1. Opioid Analgesics

Opioid analgesics remain the standard intravenous treatment for acute pain; however, their receptor-mediated side effects, including nausea, vomiting, respiratory depression, urinary retention, and pruritus, are challenging to entirely mitigate, particularly in elderly patients with declining organ function

[3]

. Consequently, multimodal analgesic approaches are frequently employed in clinical settings to minimize opioid dosages while preserving analgesic efficacy. Sufentanil, a highly selective and long-acting μ opioid receptor agonist, exhibits a strong affinity for μ1 receptors and is noted for its rapid onset, potent analgesic effect, relatively low incidence of side effects, and hemodynamic stability

[3, 4]

. In the patient-controlled intravenous analgesia (PCIA) protocol for multimodal analgesia during laparoscopic radical gastrectomy for gastric cancer, sufentanil is frequently employed as the primary agent and is often combined with other medications to enhance synergistic effects. Research has substantiated the benefits of this composite approach. Chi Yan et al.

[5]

demonstrated that the PCIA regimen incorporating dexmedetomidine with sufentanil outperforms sufentanil monotherapy in reducing postoperative pain, enhancing sedation, and improving safety for patients undergoing laparoscopic gastric cancer resection. Furthermore, the PCIA regimen combining nalbuphine with sufentanil has been shown to provide superior analgesic efficacy and safety, as well as to alleviate visceral pain through the modulation of pain-related factors

[6]

. Additionally, the PCIA regimen of sufentanil combined with dezocine offers effective sedation and analgesia, mitigates pain-related stress, and protects immune function, evidenced by its relatively minor effects on interleukin-2 and interleukin-6 levels, while also reducing the incidence of micrometastases in the bloodstream

[7]

2.2. Opioid Receptor Agonist-Antagonist

Opioid receptor agonists - antagonists are a class of drugs that have both agonistic and antagonistic activities against opioid receptors, mainly including pentazocine, butorphanol, nalbuphine, buprenorphine and dezocine, etc. Compared with simple μ receptor agonists such as morphine and fentanyl, these drugs have the advantages of definite analgesic effect, lower addiction, and fewer side effects such as coughing, itching and respiratory depression. Its pharmacological properties stem from the excitatory effects on κ -opioid receptorsand δ -opioid receptors as well as varying degrees of antagonistic effects on μ -opioid receptors. This unique mechanism of action gives it an advantage in suppressing visceral pain, while significantly reducing typical opioid adverse reactions such as nausea and vomiting, respiratory depression and intestinal paralysis

[8]

Based on the above advantages, opioid receptor agonists - antagonists play a particularly prominent role in surgical analgesia involving abdominal internal organs. A randomized controlled trial on elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer demonstrated that the patient-controlled intravenous analgesia regimen of dezocine combined with butorphanol not only effectively alleviated postoperative pain but also regulated immune function and reduced the incidence of postoperative complications

[9]

. This is consistent with the conclusions of multiple clinical studies on the use of drugs such as nalbuphine and dezocine for postoperative analgesia, all of which confirm that these drugs have better safety while achieving effective analgesia

[10, 11]

. Therefore, opioid receptor agonists - antagonists are an important component of multimodal analgesia, especially in perioperative analgesia protocols for abdominal surgery.

2.3. Non-opioid Analgesics

2.3.1. Nonsteroidal Antiinflammatory Drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs (NSAIDs) comprise a class of anti-inflammatory medications devoid of steroidal structures, including aspirin, flurbiprofen axetil, ketorolac, diclofenac, ibuprofen, peroxicam, and celecoxib. These drugs are extensively utilized in perioperative pain management. They serve not only to alleviate mild to moderate pain but also as adjunctive treatment for moderate to severe pain. The analgesic and anti-inflammatory effects of NSAIDs arise from their inhibition of cyclooxygenase, which subsequently reduces the synthesis of prostaglandins

[12]

. As a crucial element of multimodal analgesia, NSAIDs effectively decrease the need for opioid medications post-surgery, thereby minimizing adverse reactions such as nausea, vomiting, and respiratory depression, while also producing a synergistic analgesic effect.

The increasing clinical application of NSAIDs has raised significant concerns regarding their safety. A retrospective analysis involving 2,150 patients who underwent laparoscopic gastric cancer resection indicated that postoperative NSAID use may be linked to a higher incidence of complications, including anastomotic leakage, duodenal stump leakage, intra-abdominal hemorrhage, and intra-abdominal inflammation

[13]

. Regarding cardiovascular safety, findings from the PRECISION trial, a prospective randomized study conducted from 2006 to 2014 with 24,222 participants, suggest that NSAIDs should be avoided in patients at elevated risk for cardiovascular disease. If NSAIDs are deemed necessary, the lowest effective dose should be utilized, and the duration of treatment should be minimized. Notably, animal studies have not demonstrated any impact of NSAIDs on the healing strength of anastomoses

[14]

, implying that the clinical risks may be influenced by species differences, timing of administration, or individual patient factors.

Given the aforementioned potential complications, the use of NSAIDs must be meticulously assessed when developing postoperative analgesia protocols for elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer. Clinical decisions should be grounded in a thorough evaluation of each patient's individual circumstances, including cardiovascular status, renal function, and gastrointestinal history. Adhering to the principle of "the shortest course of treatment and the lowest effective dose" is essential. Priority should be given to medications such as selective COX-2 inhibitors, which exert a reduced impact on gastrointestinal and platelet functions. This approach aims to achieve effective analgesia while maximizing patient safety.

2.3.2. Paracetamol

Acetaminophen, also known as paracetamol, is one of the most popular and widely used drugs for treating pain and fever, holding a unique position among painkillers. It is not an NSAIDs drug. Unlike NSAIDs, acetaminophen has low anti-inflammatory activity and does not cause gastrointestinal damage or adverse effects on the heart and kidneys

[15]

. A number of prospective trials on acetaminophen versus placebo have shown that acetaminophen can improve pain relief, have the effect of saving opioids, increase patient satisfaction, and reduce the need for emergency drugs for burst pain. Especially its intravenous preparations, which do not go through the first stage of elimination, have a high bioavailability. However, its analgesic effect is relatively weak. It is often combined with other analgesic regimens to enhance the analgesic effect and reduce adverse reactions

[16]

2.3.3. Others

Tramadol, glucocorticoids, and non-steroidal anti-inflammatory drugs are essential components of multimodal analgesia. A prospective study by Mikami et al. evaluated the analgesic effects of an oral regimen combining tramadol and acetaminophen with celecoxib, in comparison to epidural analgesia following laparoscopic radical gastrectomy for gastric cancer. The findings demonstrated that the oral analgesic regimen is a feasible and safe method for pain management, characterized by a low incidence of adverse events and a non-invasive approach. This study indicates that the combination of tramadol and acetaminophen with celecoxib may serve as an effective option for postoperative analgesia after laparoscopic radical gastrectomy for gastric cancer

[17]

The application of glucocorticoids in perioperative analgesia can achieve ideal results, which is helpful to improve the clinical treatment effect and reduce related adverse reactions. However, for elderly patients, the use of glucocorticoids requires special caution as it may induce or aggravate common comorbidities in the elderly such as hypertension and diabetes, and increase the risk of infection, osteoporosis and peptic ulcers, etc.

[18]

Therefore, when applied in elderly patients, the benefits and risks must be strictly evaluated, and monitoring during the medication period should be strengthened.

3. Commonly Used Nerve Block Techniques in Multimodal Analgesia

3.1. Patient Controlled Epidural Analgesia (PCEA)

Epidural analgesia, achieved by placing a catheter in the epidural space and administering analgesic agents to target nerve roots directly, offers effective postoperative pain relief and diminishes the risks of pneumonia, cardiovascular, and cerebrovascular events. Historically, it was considered a fundamental analgesic strategy within the enhanced recovery after surgery framework for abdominal procedures

[19]

. Clinical investigations have demonstrated that patient-controlled epidural analgesia (PCEA) is both safe and effective for patients undergoing radical gastrectomy due to gastric cancer. In comparison to patient-controlled intravenous analgesia, PCEA significantly reduces postoperative pain scores, mitigates the body's stress response, enhances intestinal function recovery, and consequently expedites the rehabilitation process post-surgery

[20]

. Nonetheless, epidural analgesia presents certain limitations in clinical practice. The failure rate for epidural catheter placement can reach 30%, while the incidence of intraoperative and postoperative hypotension may be as high as 40%. Additionally, urinary retention occurs in 21.5% to 38.1% of cases. Elderly patients face an elevated risk of severe hypotension and complications associated with epidural techniques

[21]

. Concurrently, the advancement of minimally invasive surgical techniques has led to the widespread adoption of laparoscopic surgery for abdominal procedures, including radical gastrectomy for gastric cancer. Laparoscopic surgery offers distinct advantages over open surgery, including reduced trauma, diminished postoperative pain, less impact on respiratory function, and shorter hospital stays. Therefore, there is controversy in the academic community as to whether it is still necessary to routinely use epidural analgesia after laparoscopic surgery. Relevant retrospective research analyses indicate that for laparoscopic radical gastrectomy for gastric cancer, patient-controlled epidural analgesia may not be indispensable. Studies have shown that regardless of whether PCIA or PCEA is used after laparoscopic gastric cancer surgery, there is no significant difference in tumor recurrence rate and patient mortality

[22]

. In terms of pain control effect, postoperative complication rate and hospital stay, PCEA did not show a clear advantage over PCIA

[23]

. In conclusion, with the increasing popularity and improvement of laparoscopic technology, the traditional core position of epidural analgesia in postoperative analgesia of abdominal surgery is gradually being replaced by ultrasound-guided regional nerve block technology and multimodal analgesia regimens based on intravenous administration.

3.2. Transversus Abdominis Plane Block (TAPB)

The transversus abdominis plane block (TAPB) technique was first described by Rafi in 2001. This approach relies on neuroanatomical localization, involving the injection of local anesthetics into the fascial space between the internal oblique and transverse abdominis muscles, thereby facilitating effective regional analgesia for abdominal surgeries

[24]

. With the advent of ultrasound visualization technology, the use of TAPB in clinical settings has become increasingly prevalent. Clinicians have gradually recognized and accepted its analgesic mechanism, operational methods, injection sites, drug selection, and dosage protocols

[25]

. The indications for TAPB have continuously expanded, now encompassing nearly all types of abdominal surgeries. In laparoscopic procedures, ultrasound-guided subcostal TAPB and Petit triangle block are among the most commonly employed and effective techniques

[26]

. Notably, subcostal TAPB is particularly advantageous for upper abdominal surgeries, as it effectively blocks the sensory distribution of the T7 to T12 spinal nerves, aligning closely with the incision pain range (T6-T12) experienced during laparoscopic radical gastrectomy for gastric cancer. Clinical studies have demonstrated that ultrasound-guided subcostal TAPB provides effective analgesia following laparoscopic gastric cancer surgery and significantly reduces opioid consumption

[27]

To further optimize the analgesic effect and reduce the adverse reactions related to opioids, some studies have adopted a multimodal analgesic regimen combining bilateral double transversus abdominis plane block with patient-controlled intravenous analgesia. This protocol has been proven to significantly reduce the incidence of postoperative nausea and vomiting, improve the postoperative experience of patients, and is particularly suitable for elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer

[28]

Ropivacaine, a long-acting amide local anesthetic, is often selected for TAPB. To prevent systemic toxicity of local anesthetics and prolong the block time, Yao Xiaorong et al.

[29]

combined ropivacaine with dexmedetomidine for TAPB. Research has found that this composite protocol can improve the postoperative recovery quality of elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer, enhance the analgesic effect, prolong the duration of analgesia, reduce the dosage of postoperative intravenous analgesic drugs, and has good safety. Other clinical studies have further confirmed the efficacy and safety of dexmedetomidine as an adjuvant in TAPB.

3.3. Erector Spine Plane Block (ESPB)

The erector spinae plane block, an emerging regional analgesic technique, has demonstrated promising applications in providing analgesia for abdominal surgery due to its notable analgesic efficacy, extensive block coverage, relatively straightforward execution, and high safety profile

[30]

. The mechanism of action involves the injection of local anesthetics into the fascial plane situated between the deep surface of the erector spinae muscle and the transverse process. This allows the anesthetic agents to diffuse into the paravertebral space, effectively blocking both the ventral and dorsal branches of the spinal nerves. In the context of laparoscopic radical gastrectomy for gastric cancer, this technique theoretically encompasses the pain-controlled regions (T6-T12) associated with surgical incisions and visceral interventions, thereby fulfilling the requirements for surgical analgesia while mitigating the risks of circulatory fluctuations and respiratory depression that may arise from excessive segmental block.

Clinical studies have confirmed that ultrasound-guided ESPB can effectively alleviate postoperative pain after laparoscopic gastric cancer surgery, reduce the dosage of opioids during the perioperative period, and help alleviate the inflammatory response caused by surgical trauma

[31]

. Compared with traditional epidural analgesia, ESPB operation is more convenient, and the risk of serious complications (such as epidural hematoma and abnormally extensive block) is significantly reduced. However, the application of this technology in abdominal surgeries, especially radical gastrectomy for gastric cancer, is still in the stage of exploration and optimization. The current research focuses on the optimal concentration and volume of ropivacaine, the influence of injection speed on the onset time and effect of block

[32]

, and its impact on the hemodynamic stability of elderly patients. In addition, the duration of a single block is limited. To provide continuous analgesia, continuous catheter placement (ESPB) has become an important direction for prolongating analgesia time. However, the optimal catheter placement position, administration mode, and long-term safety in abdominal surgery still require more high-quality clinical studies to be clarified

[30]

In conclusion, ESPB provides an effective multimodal analgesic component for laparoscopic radical gastrectomy for gastric cancer. However, the standardization and optimization of its clinical application plan, especially for elderly patients and those seeking long-acting analgesia, are key issues that need to be addressed in future research.

3.4. Quadratus Lumborum Block (QLB)

The quadratus lumborum block is a trunk nerve block technique initially described by Blanco. This technique involves the injection of local anesthetics into the fascial space surrounding the quadratus lumborum, thereby providing simultaneous analgesic effects that encompass both the body surface and internal organs during abdominal and hip surgeries. Theoretically, the blocked dermatomes can extend from T6 to L1

[33]

. Research indicates that this technique effectively reduces resting visual analogue scale scores in elderly patients at various time points following laparoscopic radical gastrectomy for gastric cancer. Furthermore, it may enhance postoperative cognitive function and improve patient prognosis by alleviating pain and stress

[34]

The clinical application of the quadratus lumborum block encounters several challenges. Notably, there are substantial individual variations in the block plane and its efficacy. Depending on the insertion paths and injection sites, this technique can be categorized into various methods, including the lateral, posterior, and anterior approaches

[35]

. While this technological diversity offers flexibility, it also results in issues such as low operational standardization and inconsistent predictability of outcomes. Consequently, it is challenging to rely solely on this technique to provide comprehensive analgesia in the surgical area for all patients undergoing gastric cancer surgery. Therefore, in clinical practice, the quadratus lumborum block is frequently employed as a critical component of multimodal analgesia regimens rather than as the exclusive analgesic approach.

3.5. Paravertebral Thoracic Nerve Block (PVNB)

Paravertebral nerve block (PVNB) achieves a segmental blockade of the motor, sensory, and sympathetic nerves on the ipsilateral side by administering local anesthetics at the nerve root outlet of the thoracic paravertebral space. This technique is crucial for regional anesthesia and postoperative analgesia in thoracic and abdominal surgeries

[36]

. Regarding postoperative analgesia, research indicates that the analgesic efficacy of PVNB can be comparable to that of epidural analgesia, effectively reducing the incidence of adverse reactions such as nausea, vomiting, urinary retention, and hypotension. Consequently, it has gained widespread application in thoracic surgeries

[37]

. In contrast, the use of PVNB in abdominal surgery is relatively limited. Nevertheless, existing studies suggest that, without primarily considering its potential effects on hemodynamics

[38]

, ultrasound-guided bilateral paravertebral nerve block for patients undergoing radical gastrectomy for gastric cancer can yield significant clinical benefits and effective postoperative analgesia

[39]

. A prospective randomized controlled trial involving elderly patients with gastric cancer further demonstrated that preoperative bilateral PVNB can significantly decrease the dosage of general anesthetics, shorten patient recovery time, and may positively influence postoperative cognitive function. These findings imply that PVNB, as a vital component of multimodal analgesia, holds considerable promise for optimizing perioperative management in major abdominal surgeries, particularly radical gastrectomy for gastric cancer.

4. Common Traditional Chinese Medicine Analgesic Methods in Multimodal Analgesia

Transcutaneous electrical acupoint stimulation (TEAS) is a non-invasive physical therapy technique that has evolved from traditional Chinese acupuncture. This approach integrates the benefits of acupoint stimulation with transcutaneous nerve electrical stimulation, characterized by its ease of use, safety, and non-invasive nature. TEAS has found extensive application in peripheral operative management in China

[40]

. Research indicates that TEAS can serve multiple functions during the perioperative period by modulating the nervous, endocrine, and immune systems. Its benefits include facilitating pain management, reducing postoperative nausea and vomiting, enhancing immune function, promoting gastrointestinal recovery, and decreasing the incidence of postoperative complications

[41]

In elderly patients undergoing laparoscopic gastric cancer surgery, the combined use of transcutaneous electrical acupoint stimulation (TEAS) and transversus abdominis plane block has been shown to produce a synergistic effect. Clinical randomized controlled trials have demonstrated that this combination significantly alleviates postoperative pain, shortens the time to first flatulence, reduces the incidence of postoperative nausea and vomiting, and partially restores the balance of T lymphocyte subsets, thereby enhancing immune function

[41]

. Collectively, these effects contribute to improved quality of early postoperative recovery for patients. Furthermore, additional studies indicate that the perioperative application of TEAS can decrease the incidence of postoperative fatigue syndrome in elderly patients. This mechanism may be associated with increased release of endogenous β-endorphins, inhibition of inflammatory responses, and alleviation of oxidative stress

[42]

. Consequently, TEAS combined with regional nerve block can serve as a vital non-pharmaceutical intervention to optimize perioperative management and promote rapid recovery in elderly patients undergoing laparoscopic gastric cancer surgery.

5. Others

Individualized analgesia regimens and optimized early postoperative fluid and food intake can effectively facilitate recovery in patients undergoing laparoscopic gastric cancer resection without increasing the risk of complications, such as anastomotic fistula

[43]

. In this patient population, the implementation of an acute pain service model, which involves nurse execution and joint supervision by anesthesiologists and specialists, can significantly reduce postoperative pain, promote the recovery of physiological functions, and improve patient satisfaction with analgesic management

[44]

. Additionally, research has demonstrated that postoperative consumption of green tea is a safe intervention that can diminish pain intensity following laparoscopic gastric cancer resection and aid in the recovery process. Within the enhanced recovery after surgery program, green tea serves as an adjunct to enhance analgesic and anti-inflammatory effects

[45]

6. Summary

Adequate postoperative analgesia is a fundamental component of the enhanced recovery after surgery (ERAS) protocol and serves as a critical indicator for assessing surgical effectiveness, rehabilitation outcomes, quality of medical care, and patient satisfaction. With advancements in medical technology, the promotion of patient-centered care, the widespread adoption and refinement of endoscopic techniques, the introduction of novel analgesic agents, and ongoing innovations in analgesic methodologies, the options for multimodal analgesia following laparoscopic gastric cancer resection in elderly patients are becoming increasingly varied. These developments enhance the ability to effectively manage postoperative pain, decrease the incidence of complications, and expedite the recovery of gastrointestinal function, thereby facilitating rapid postoperative recovery and positively influencing long-term prognoses for patients.

Abbreviations

ERAS	Enhanced Recovery After Surgery
TEAS	Transcutaneous Electrical Acupoint Stimulation
QLB	Quadratus Lumborum Block
PNVB	Paravertebral Nerve Block
ESPB	Erector Spine Plane Block
TAPB	Transversus Abdominis Plane Block
PCEA	Patient Controlled Epidural Analgesia
PCIA	Patient Controlled Intravenous Analgesia
NSAIDs	Nonsteroidal Antiinflammatory Drugs

Author Contributions

Li Liu: Conceptualization, Data curation, Formal analysis, Methodology, Resources, Software, Writing – original draft

Dan Zhou: Conceptualization, Project administration, Supervision, Validation, Writing – review & editing

Conflicts of Interest

The authors declare that they have no conflict of interest.

References

[1]	Ministry of Civil Affairs of the People's Republic of China. Statistical Bulletin on the Development of Civil Affairs in 2018 [R/OL]. (2019-08-15) [2020-05-20].
[2]	Zheng Minhua, Ma Junjun, Wu Chao. Progress in minimally invasive surgery in the past 20 years and future development trends [J]. Chinesof Practical Surgery, 2020, 40 (01): 23-26+32. https://doi.org/10.19538/j.cjps.issn1005-2208.2020.01.03
[3]	Chen Li, Zhao Yuehui, Liu Xiaoli. Progress in the Application of Sufentanil in Cancer Pain Treatment [J]. Chinese Journal of Pan Medicine, 2018, (11): 859-862.
[4]	Wang Xiaoge, Ding Meng, Sun Yu. Progress in the Clinical Application of Sufentanil [J]. Tianjin Pharmaceutical Journal. 2022, (03): 74-78.
[5]	Chi Yan, Wang Yan. Effect of Dexmedetomidine Combined with Sufentanil on Postoperative Analgesia in Patients Undergoing Laparosco Gastrectomy for Gastric Cancer [J]. Northern Pharmacy, 2021, 18(11): 47-49.
[6]	Gan Lu, Ge Lihua, Shi Song, et al. Application of Nalbuphine in Postoperative Multimodal Analgesia for Eldetients Undergoing Laparoscopic Radical Gastrectomy for Gastric Cancer [J]. Chinese Journal of Gerontology. 2023, (13): 3145-3149.
[7]	Sun Huifang, Kuang Yan, Luo Haiming, et al. Effects of Sufentanil Combined with Dezoostoperative Patient-Controlled Intravenous Analgesia on Pain Stress and T-Cell Subsets in Patients Undergoing Laparoscopic Radical Gastrectomy for Gastric [J]. Progress in Modern Biomedicine, 2022, (01): 63-67. https://doi.org/10.13241/j.cnki.pmb.2022.01.010
[8]	Cheng zequan, Xiao guowei, Ao jian, et al. Research Progress on Analgesic Effects and Adverse Reactions of Opioid Receptor Agonist-Antagonists [J]. Chinese Pharmacy, 2023, 34(18): 2299-2304.
[9]	Xian Feng, Hong Tao. Effect of Dezocine Combined with Butorphanol on Postoperative Analgesia, Anesthesia Quality, and Immune Functiorly Patients Undergoing Laparoscopic Radical Gastrectomy for Gastric Cancer [J]. Chinese Journal of Gerontology, 2018, (06): 1383-1385.
[10]	Shen Xuehua. Effect of Ultrasound-guided Transversus Abdominis Plane Block Combined with Nalbuphine on Postoperative Analgesia in Patientdergoing Laparoscopic Radical Gastrectomy for Gastric Cancer [J]. Chinese Community Doctor, 2021, 37 (29): 52-53.
[11]	Cheng Chen, Chang Jiang, Song Yongsheng, et al. Effect of ultrasound-guided transversus abdominis plane block combined with nalbupostoperative analgesia and inflammatory response in patients with laparoscopic gastric cancer [J]. Anhui Medical and Pharmaceutical, 2020, 24 (07): 1351-1355.
[12]	Expert Committee on Accelerated Rehabilitaion Surgery, Medical Administration Center, National Health Commission. Chinese Expert Consensus on the Clinical Application of Perioperative Non-steroidal Anti-inflammatory Drugs in Accelerated Rehabilitation Surgery [J]. Chie Journal of General Surgery, 2019, 34(3): 283-288.
[13]	Kim SJ, Jeon CH, Lee HH, et al. Impact of postoperative NSAIDs (IV-PCA) use on short-term outcomes after laparoscopic gastrectomy for the patients of gastric cancer [J]. Surg Endosc. 2023 Feb; 37(2): 1123-1131. https://doi.org/10.1007/s00464-022-09600-4
[14]	YaDeau JT, Tedore T, Goytizolo EA, et al. Lumbar plexus blockade reduces pain after hip arthroscopy: a prospectiverandomized controlled trial [J]. Anesth Analg, 2012, 115: 968-972. https://doi.org/10.1213/ANE.0b013e318265bacd
[15]	Vladimir V. ouznetsov. Exploring acetaminophen prodrugs and hybrids: a review [J]. RSC Advances. 2024, 14(14): 9691-9715. https://doi.org/10.1039/d4ra00365a
[16]	Ebara, Gen; Sakuramoto, Shinichi; Matsui, Kazuaki; et al. Efficacy and safety of patient-controlled thoracic epidural analgesia alone versus patient-controlled intravenous analgesia with acetaminophen after laparoscopic distal gastrectomy for gastric cancer: a propensity score-matched analysis [J]. Surgical Endoscopy. 2023, 37(11): 8245-8253. https://doi.org/10.1007/s00464-023-10370-w
[17]	Mikami, Jota; Takiguchi, Shuji; Miyazaki, Yasuhiro; et al. Novel management of postoperative pain using only oral analgesics after LADG [J]. Surgery Today. 2016, 46(1): 117-122. https://doi.org/10.1007/s00595-015-1155-x
[18]	Yang Jingshu. Application of Preoperative Glucocorticoids in the Fast Track Surgery of Gastric Cancer [D]. Henan University, 2023.
[19]	Mortensen K, Nilsson M, Slim K, et al. Enhanced recovery after surgery (ERAS®) group. Enhanced recovery after surgery (ERAS®) group consensus guidelines for enhanced recovery after gastrectomy: enhanced recovery after surgery (ERAS®) society recommendations. Br J Surg. 2014; 101: 1209–1229.
[20]	Zhu Z, Wang C, Xu C, et al. Influence of patient-controlled epidural analgesia versus patient-controlled intravenous analgesia on postoperative pain control and recovery after gastrectomy for gastric cancer: a prospective randomized trial. Gastric Cancer. 2013 Apr; 16(2): 193-200. https://doi.org/10.1007/s10120-012-0168-z
[21]	Wang L, Li X, Chen H, et al. Effect of patient-controlled epidural analgesia versus patient-controlled intravenous analgesia on postoperative pain management and short-term outcomes after gastric cancer resection: a retrospective analysis of 3,042 consecutive patients between 2010 and 2015. J Pain Res. 2018 Sep 5; 11: 1743-1749.
[22]	Shin S, Kim HI, Kim NY, et al. Effect of postoperative analgesia technique on the prognosis of gastric cancer: a retrospective analysis. Oncotarget. 2017 Oct 20; 8(61): 104594-104604. https://doi.org/10.18632/oncotarget.21979
[23]	Kikuchi S, Kuroda S, Nishizaki M, et al. Comparison of the Effects of Epidural Analgesia and Patient-controlled Intravenous Analgesia on Postoperative Pain Relief and Recovery After Laparoscopic Gastrectomy for Gastric Cancer. Surg Laparosc Endosc Percutan Tech. 2019 Oct; 29(5): 405-408.
[24]	Rafi AN. Abdominal field block: a new approach via the lumbar triangle. Anaesthesia. 2001 Oct; 56(10): 1024-6. https://doi.org/10.1046/j.1365-2044.2001.02279-40.x
[25]	Han Yongjing, Jia Zhen. Research Progress on Analgesic Effect of Transversus Abdominis Plane Block after Laparoscopic Surgery [J]. Advances in Clinical Medicine. 2023, 13(2): 2422-2427.
[26]	Tsai, H. C., Yoshida, T., Chuang, T. Y., et al. (2017) Transversus Abdominis Plane Block: An Updated Review of Anatomy and Techniques. BioMed Research International, 2017.
[27]	Yoon, Susie, Song, Gyu Young, Lee, Jihye, et al. Ultrasound-guided bilateral subcostal transversus abdominis plane block in gastric cancer patients undergoing laparoscopic gastrectomy: a randomised-controlled double-blinded study [J]. Surgical Endoscopy. 2022, 36(2): 1044-1052. https://doi.org/10.1007/s00464-021-08370-9
[28]	Chen Nan. Evaluation of the Analgesic Effect of BD-TAPB on Postoperative Pain after Laparoscopic Radical Gastrectomy [D]. Dalian Medical University, 2022.
[29]	Yao Xiaorong. The Effect of Dexmedetomidine Combined with Transversus Abdominis Plane Block on Postoperative Recovery in Elderly Patients Undergoing opic Radical Gastrectomy for Gastric Cancer [D]. Shanxi Medical University, 2023.
[30]	Fang Liang, Wang Haiying. Progress in the clinical application of ultrasound-guided continuous erector spinae plane block [J]. Guizhou Medial Journal, 2024, 48(05): 704-710.
[31]	Hu H Q, Bao H G, Shan T, et al. Application effect of erector spinae plane block with different concentrations of ropivacalaparoscopic radical gastrectomy [J]. Journal of Clinical Anesthesiology, 2020, 36(1): 997-1001.
[32]	Hu Haiqing, Bao Hongguang, Shan Tao, et al. Analgesic effect of different injection rates of ropivacaine in erector spinae plane block in laparoscopic radical gastrectomy for garic cancer [J]. Chinese Journal of Pain Medicine, 2022, (Issue 6): 789-793.
[33]	Carline L, Mcleod GA, Lamb C. A cadaver study comparing spread of dye and nerve involvement after three different quadratus lumborum blocks. Br J Anaesth. 2016; 117(3): 387–394. https://doi.org/10.1093/bja/aew224
[34]	Zhu, Manhua, Qi, Yong, He, Huijuan, et al. Effect of quadratus lumborum block on postoperative cognitive function in elderly patients undergoing laparoscopic radical gastrectomy: a randomized controlled trial [J]. BMC Geriatrics. 2021, 21(1): 1-9.
[35]	Haskins, SC; Tseng, A; Zhong, HY; et al. Anterior Quadratus Lumborum Block Does Not Provide Superior Pain Control after Hip Arthroscopy: A Double-blinded Randomized Controlled Trial [J]. Anesthesiology. 2021, 135(3): 433-441. https://doi.org/10.1097/ALN.0000000000003853
[36]	Li Yue, Yin Guojiang, Song Xiaoyang, et al. Research Progress on the Application of Ultrasound-Guided Regional Block in Unilateral Eraperitoneal Organ Surgery [J]. Medical Research and Combat Casualty Care, 2023, 36(03): 328-332.
[37]	Alizai Q, Arif MS, Colosimo C, et al. Beyond the short-term relief: Outcomes of geriatric rib fracture patients receiving paravertebral nerve blocks and epidural analgesia. Injury. 2024 Jan; 55(1): 111184. https://doi.org/10.1016/j.injury.2023.111184
[38]	Yanhong Shang, Fuwei Qi, Zhong Zheng, et al. Efect of bilateral paravertebral nerve block on cognitive function in elderly patients undergoing radical gastrectomy for gastric cancer: a prospective randomized double-blind controlled trial [J]. BMC Anesthesiology (2022) 22: 224. https://doi.org/10.1186/s12871-022-01764-9
[39]	Wang S, Yang L. Application efect of ultrasound-guided paravertebral nerve block in radical gastrectomy for elderly patients with gastric cancer [J]. Clin Med Res Pract. 2020; 5(06): 7–9.
[40]	Ruyi Xing, Yang Yang, Min Zhang, et al. Effect of Transcutaneous Electrical Acupoint Stimulation Combined with Transversus Abdominis Plane Block on Postoperative Recovery in Elderly Patients Undergoing Laparoscopic Gastric Cancer Surgery: A Randomized Controlled Trial [J]. Pain and therapy. 2023, 11(4): 1327-1339. https://doi.org/10.1007/s40122-022-00429-2
[41]	Liw J, Gao C, An L X, et al. Perioperative transcutaneous electrical acupoint stimulation for improving postoperative gastrointestinal function: A randomized controlled trial [J]. J Integr Med, 2021, 19(3): 211-8. https://doi.org/10.1016/j.joim.2021.01.005
[42]	Jing CHENG; Shiyi HU; Yuru FANG; Guixia CAO; Tao JIANG; Yiqiao WANG. Effect of perioperative transcutaneous electrical acupoint stimulation on postoperative fatigue syndrome in elderly patients [J]. Chinese Acupuncture&Moxibustion. 2025, 45(8): 1071-1077. https://doi.org/10.13703/j.0255-2930.20240814-k0004
[43]	M Nakagawa, C Tomii, M Inokuchi, et al. Feasibility of a Clinical Pathway With Early Oral Intake and Discharge for Laparoscopic Gastrectomy [J]. Scandinavian Journal Of Surgery: SJS: Official Organ For The Finnish Surgical Society And The Scandinavian Surgical Society. 2018, 107(3): 218-223. https://doi.org/10.1177/1457496917748228
[44]	Miao Zhang, Rui Li, Hong Chen, et al. Application and efffcacy evaluation of an NBASS-APS pain management model in postoperative analgesia for gastric cancer patients [J]. JBUON 2018; 23(5): 1426-1431.
[45]	Liu D, Jing X, Cao S, et al. Impact of drinking Chinese green tea on postoperative short outcomes for gastric cancer: a randomized controlled trial [J]. Eur J Clin Nutr. 2021 Nov; 75(11): 1568-1577. https://doi.org/10.1038/s41430-021-00868-8

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Liu, L., Zhou, D. (2026). Research Progress of Multimodal Analgesia in Postoperative Analgesia of Elderly Patients After Laparoscopic Gastric Cancer Surgery. International Journal of Anesthesia and Clinical Medicine, 14(1), 65-72. https://doi.org/10.11648/j.ijacm.20261401.21

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Liu, L.; Zhou, D. Research Progress of Multimodal Analgesia in Postoperative Analgesia of Elderly Patients After Laparoscopic Gastric Cancer Surgery. Int. J. Anesth. Clin. Med. 2026, 14(1), 65-72. doi: 10.11648/j.ijacm.20261401.21

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Liu L, Zhou D. Research Progress of Multimodal Analgesia in Postoperative Analgesia of Elderly Patients After Laparoscopic Gastric Cancer Surgery. Int J Anesth Clin Med. 2026;14(1):65-72. doi: 10.11648/j.ijacm.20261401.21

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@article{10.11648/j.ijacm.20261401.21,
  author = {Li Liu and Dan Zhou},
  title = {Research Progress of Multimodal Analgesia in Postoperative Analgesia of Elderly Patients After Laparoscopic Gastric Cancer Surgery},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {14},
  number = {1},
  pages = {65-72},
  doi = {10.11648/j.ijacm.20261401.21},
  url = {https://doi.org/10.11648/j.ijacm.20261401.21},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20261401.21},
  abstract = {Postoperative pain is a major clinical challenge for surgical patients, often leading to adverse physiological and psychological events such as hypertension, myocaial ischemia, gastrointestinal dysfunction, delirium, and sleep disorders. Effective postoperative analgesia is crucial as it mitigates excessive stress responses, thereby playing a key role in ensutient safety and promoting recovery. Traditional analgesic methods often rely heavily on single-drug regimens, particularly opioids, which are associated with a high incidence of severe adverse effects such asy depression, nausea, vomiting, and constipation. In response, multimodal analgesia has emerged as a superior paradigm. This strategy integrates drugs and regional techniques with different mechanisf action—for example, combining nonsteroidal anti-inflammatory drugs (NSAIDs), local anesthetics, and adjuvant drugs—to achieve synergistic analgesic effects while minimizine dosage and side effects of individual components. With the rapid development of Enhanced Recovery After Surgery (ERAS) concepts, the advantages of multimodal analgesia have become increasingly promechnological advancements, such as ultrasound-guided nerve blocks and advanced patient-controlled analgesia pumps, have made these regimens more refined and individualized. As a cornerstone of EAS pathways, multimodal analgesia effectively controls pain, significantly reduces opioid-related complications, promotes early mobilization and functional recovery, and shortens length of stay, thereby utilizing medical resources moreefficiently. This study reviews various strategies for postoperative pain management in patients undergoing laparoscopic radical gastrectomy for gastric cancer.},
 year = {2026}
}

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TY  - JOUR
T1  - Research Progress of Multimodal Analgesia in Postoperative Analgesia of Elderly Patients After Laparoscopic Gastric Cancer Surgery
AU  - Li Liu
AU  - Dan Zhou
Y1  - 2026/03/27
PY  - 2026
N1  - https://doi.org/10.11648/j.ijacm.20261401.21
DO  - 10.11648/j.ijacm.20261401.21
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 65
EP  - 72
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20261401.21
AB  - Postoperative pain is a major clinical challenge for surgical patients, often leading to adverse physiological and psychological events such as hypertension, myocaial ischemia, gastrointestinal dysfunction, delirium, and sleep disorders. Effective postoperative analgesia is crucial as it mitigates excessive stress responses, thereby playing a key role in ensutient safety and promoting recovery. Traditional analgesic methods often rely heavily on single-drug regimens, particularly opioids, which are associated with a high incidence of severe adverse effects such asy depression, nausea, vomiting, and constipation. In response, multimodal analgesia has emerged as a superior paradigm. This strategy integrates drugs and regional techniques with different mechanisf action—for example, combining nonsteroidal anti-inflammatory drugs (NSAIDs), local anesthetics, and adjuvant drugs—to achieve synergistic analgesic effects while minimizine dosage and side effects of individual components. With the rapid development of Enhanced Recovery After Surgery (ERAS) concepts, the advantages of multimodal analgesia have become increasingly promechnological advancements, such as ultrasound-guided nerve blocks and advanced patient-controlled analgesia pumps, have made these regimens more refined and individualized. As a cornerstone of EAS pathways, multimodal analgesia effectively controls pain, significantly reduces opioid-related complications, promotes early mobilization and functional recovery, and shortens length of stay, thereby utilizing medical resources moreefficiently. This study reviews various strategies for postoperative pain management in patients undergoing laparoscopic radical gastrectomy for gastric cancer.
VL  - 14
IS  - 1
ER  -

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Li Liu

Department of Anesthesiology, Deyang People's Hospital, Deyang Clinical Medical College, Chengdu University of Traditional Medicine, Deyang, China

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http://orcid.org/0009-0007-7513-7975
Dan Zhou

Department of Anesthesiology, Deyang People's Hospital, Deyang Clinical Medical College, Chengdu University of Traditional Medicine, Deyang, China

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APA Style

Liu, L., Zhou, D. (2026). Research Progress of Multimodal Analgesia in Postoperative Analgesia of Elderly Patients After Laparoscopic Gastric Cancer Surgery. International Journal of Anesthesia and Clinical Medicine, 14(1), 65-72. https://doi.org/10.11648/j.ijacm.20261401.21

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ACS Style

Liu, L.; Zhou, D. Research Progress of Multimodal Analgesia in Postoperative Analgesia of Elderly Patients After Laparoscopic Gastric Cancer Surgery. Int. J. Anesth. Clin. Med. 2026, 14(1), 65-72. doi: 10.11648/j.ijacm.20261401.21

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AMA Style

Liu L, Zhou D. Research Progress of Multimodal Analgesia in Postoperative Analgesia of Elderly Patients After Laparoscopic Gastric Cancer Surgery. Int J Anesth Clin Med. 2026;14(1):65-72. doi: 10.11648/j.ijacm.20261401.21

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@article{10.11648/j.ijacm.20261401.21,
  author = {Li Liu and Dan Zhou},
  title = {Research Progress of Multimodal Analgesia in Postoperative Analgesia of Elderly Patients After Laparoscopic Gastric Cancer Surgery},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {14},
  number = {1},
  pages = {65-72},
  doi = {10.11648/j.ijacm.20261401.21},
  url = {https://doi.org/10.11648/j.ijacm.20261401.21},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20261401.21},
  abstract = {Postoperative pain is a major clinical challenge for surgical patients, often leading to adverse physiological and psychological events such as hypertension, myocaial ischemia, gastrointestinal dysfunction, delirium, and sleep disorders. Effective postoperative analgesia is crucial as it mitigates excessive stress responses, thereby playing a key role in ensutient safety and promoting recovery. Traditional analgesic methods often rely heavily on single-drug regimens, particularly opioids, which are associated with a high incidence of severe adverse effects such asy depression, nausea, vomiting, and constipation. In response, multimodal analgesia has emerged as a superior paradigm. This strategy integrates drugs and regional techniques with different mechanisf action—for example, combining nonsteroidal anti-inflammatory drugs (NSAIDs), local anesthetics, and adjuvant drugs—to achieve synergistic analgesic effects while minimizine dosage and side effects of individual components. With the rapid development of Enhanced Recovery After Surgery (ERAS) concepts, the advantages of multimodal analgesia have become increasingly promechnological advancements, such as ultrasound-guided nerve blocks and advanced patient-controlled analgesia pumps, have made these regimens more refined and individualized. As a cornerstone of EAS pathways, multimodal analgesia effectively controls pain, significantly reduces opioid-related complications, promotes early mobilization and functional recovery, and shortens length of stay, thereby utilizing medical resources moreefficiently. This study reviews various strategies for postoperative pain management in patients undergoing laparoscopic radical gastrectomy for gastric cancer.},
 year = {2026}
}

Copy | Download

TY  - JOUR
T1  - Research Progress of Multimodal Analgesia in Postoperative Analgesia of Elderly Patients After Laparoscopic Gastric Cancer Surgery
AU  - Li Liu
AU  - Dan Zhou
Y1  - 2026/03/27
PY  - 2026
N1  - https://doi.org/10.11648/j.ijacm.20261401.21
DO  - 10.11648/j.ijacm.20261401.21
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 65
EP  - 72
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20261401.21
AB  - Postoperative pain is a major clinical challenge for surgical patients, often leading to adverse physiological and psychological events such as hypertension, myocaial ischemia, gastrointestinal dysfunction, delirium, and sleep disorders. Effective postoperative analgesia is crucial as it mitigates excessive stress responses, thereby playing a key role in ensutient safety and promoting recovery. Traditional analgesic methods often rely heavily on single-drug regimens, particularly opioids, which are associated with a high incidence of severe adverse effects such asy depression, nausea, vomiting, and constipation. In response, multimodal analgesia has emerged as a superior paradigm. This strategy integrates drugs and regional techniques with different mechanisf action—for example, combining nonsteroidal anti-inflammatory drugs (NSAIDs), local anesthetics, and adjuvant drugs—to achieve synergistic analgesic effects while minimizine dosage and side effects of individual components. With the rapid development of Enhanced Recovery After Surgery (ERAS) concepts, the advantages of multimodal analgesia have become increasingly promechnological advancements, such as ultrasound-guided nerve blocks and advanced patient-controlled analgesia pumps, have made these regimens more refined and individualized. As a cornerstone of EAS pathways, multimodal analgesia effectively controls pain, significantly reduces opioid-related complications, promotes early mobilization and functional recovery, and shortens length of stay, thereby utilizing medical resources moreefficiently. This study reviews various strategies for postoperative pain management in patients undergoing laparoscopic radical gastrectomy for gastric cancer.
VL  - 14
IS  - 1
ER  -

Copy | Download