To observe the clinical efficacy and safety of ropivacaine for erector spinae plane block (ESPB) combined with total intravenous anesthesia (TIVA) in patients undergoing colorectal cancer surgery.

Patients with colorectal cancer were randomly divided into treatment and control groups. Before the general anesthesia induction, treatment group received deep injection of 0.375% ropivacaine solution (25 mL) for local anesthesia in the erector spinae plane. Two groups received anesthesia induction with 0.05 mg·kg^-1 midazolam + 0.4 μg·kg^-1 sufentanil + 1.5 mg·kg^-1 propofol + 0.15 mg·kg^-1 cisatracurium, and anesthesia maintenance with 3-4 mg·L^-1 propofol + 0.5-1.0 μg·kg^-1 sufentanil + 0.05-0.10 mg·kg^-1 cisatracurium. The sufentanil dosage, hemodynamics, visual analogue scale (VAS) and Ramsay sedation scores, interleukin (IL)-6 and cortisol levels and safety were compared between two groups.

Treatment group were enrolled 57 cases, 5 cases dropped out, and 52 cases were finally included in the statistical analysis. Control group were enrolled 55 cases, 3 cases dropped out, and 52 cases were finally included in the statistical analysis. At extubation, heart rates of treatment and control groups were (89.54±5.41) and (101.98±8.58) beat·min^-1, mean arterial pressures were (83.60±7.48) and (93.12±7.35) mmHg, and the differences were statistically significant (all P<0.05). Intraoperative sufentanil dosages of treatment and control groups were (16.35±2.54) and (23.77±3.02) μg, VAS scores at 24 h after operation were (2.98±0.42) and (3.67±0.58) points, IL-6 levels at 24 h after operation were (17.92±2.41) and (28.12±3.81) ng·L^-1, cortisol levels at 24 h after operation were (154.88±24.06) and (187.46±27.51) ng·mL^-1, respectively; the differences were statistically significant (all P<0.05). Ramsay scores at 1 and 24 h postoperatively showed no statistically significant differences between and within groups (all P>0.05). The adverse drug reactions of treatment group were block site hematoma, nausea and vomiting, while those in control group were nausea and vomiting, hypotension and delirium. The incidences of total adverse drug reactions in the treatment and control groups were 11.54% and 21.15%, without significant difference (P>0.05).

Ropivacaine ESPB combined with TIVA can help the patients undergoing colorectal cancer surgery to maintain stable intraoperative hemodynamics, reduce sufentanil consumption and pain, decrease postoperative inflammatory and stress responses, without increasing the incidence of adverse drug reactions.