Quality of postoperative recovery in patients undergoing laparoscopic colorectal cancer resection as affected by transversus abdominis plane block combined with moderate neuromuscular blockade: a randomized controlled trial

Postoperative recovery quality in laparoscopic surgery may benefit from deep neuromuscular blockade, whereas the effects of combining transversus abdominis plane block (TAPB) with moderate neuromuscular blockade in this regard remain unreported. This work investigated whether moderate neuromuscular blockade differs from deep neuromuscular blockade in terms of postoperative recovery quality in patients undergoing laparoscopic surgery with routine TAPB, to provide evidence-based support for optimizing perioperative neuromuscular blockade strategies. 110 patients undergoing laparoscopic colorectal cancer surgery were randomized to moderate (train-of-four count 1–2) or deep (post-tetanic count 1–2) neuromuscular block, with both groups undergoing TAPB. The primary outcome was recovery quality assessed by the Quality of Recovery-40 (QoR-40) on postoperative day 1 (POD1). No statistically significant between-group differences in mean POD1 QoR-40 scores were found (172.18 ± 6.78 vs. 172.51 ± 6.89; 95% CI − 2.91 to 2.26; P = 0.802), with no significant differences across the scale’s five subdomains. During TAPB application for laparoscopic colorectal cancer resection, no clinically meaningful differences in postoperative recovery quality were identified between moderate and deep neuromuscular blockade. Chinese Clinical Trial Registry, ChiCTR2500103278, registered 27 May 2025.