该研究旨在评估加速康复外科（ERAS）途径和减少阿片类药物的使用对全身麻醉（GA）下接受腹腔镜手术的老年结直肠癌（CRC）患者术后结局的影响。来自 99 名老年人的临床数据对2021年4月至2023年4月在河北北方大学第一附属医院接受腹腔镜结直肠癌手术的患者进行回顾性分析，并根据所接受的疼痛控制措施的方法进行分组。 99例患者中，51例接受常规剂量的阿片类药物（常规组），48例患者根据ERAS原则接受减少剂量的阿片类药物治疗（低剂量组）。比较两组围手术期特征、术后疼痛程度、认知功能、血清生化指标水平及不良反应。低剂量组与常规组比较首次排气时间、排便时间、睡前活动时间( p<0.05）。术后第一天，低剂量组简易精神状态检查（MMSE）评分高于常规组（p<0.05）。术后，两组血清脑源性神经营养因子（BDNF）水平均下降，而神经元特异性烯醇化酶（NSE）和5-羟色胺（5-HT）水平均升高。然而，与常规组相比，低剂量组的BDNF水平较高，NSE和5-HT水平较低（p<0.05）。低剂量组的不良反应发生率低于常规组（p<0.05）。ERAS方案和接受GA手术的CRC患者减少阿片类药物的使用与镇痛效果相关，与传统阿片类药物的使用相当。减少阿片类药物的剂量可以减轻结直肠癌手术患者的认知障碍并降低不良反应的发生率。

The study aimed to assess the impact of the enhanced recovery after surgery (ERAS) pathways and the reduced use of opioids on postoperative outcomes in elderly colorectal cancer (CRC) patients who underwent laparoscopic surgery under general anesthesia (GA).Clinical data from 99 elderly patients who underwent laparoscopic CRC surgery in the First Affiliated Hospital of Hebei North University from April 2021 to April 2023 were retrospectively analyzed and grouped based on the method of pain control measures received. Of 99 patients, 51 received conventional doses of opioid drugs (conventional group), and 48 patients were treated with reduced doses of opioids based on the principles of ERAS (low-dose group). Perioperative characteristics, postoperative pain level, cognitive function, serum biochemical index levels, and adverse reactions were compared between the two groups.The first exhaust time, defecation time, and bedtime activity time of the low-dose group were compared to the conventional group (p<0.05). On the first day after the surgery, the mini-mental state examination (MMSE) score of the low-dose group was higher than the conventional group (p<0.05). After the surgery, the levels of serum brain-derived neurotrophic factor (BDNF) decreased in both groups, while the levels of neuron-specific enolase (NSE) and 5-hydroxytryptamine (5-HT) increased. However, compared to the conventional group, the low-dose group had higher levels of BDNF and lower levels of NSE and 5-HT (p<0.05). The incidence of adverse reactions in the low-dose group was lower than that in the conventional group (p<0.05).ERAS protocol and the reduced use of opioid drugs in CRC patients who underwent surgery under GA is associated with an analgesic effect that is comparable to that of conventional opioid use. Reduced dosage of opioid drugs lessened cognitive impairment and lowered the incidence of adverse reactions in surgical patients with CRC.