Effect of transcutaneous electrical acupoint stimulation on postoperative analgesia after ureteroscopic lithotripsy: a randomized controlled trial

Abstract

Transcutaneous electrical acupoint stimulation (TEAS) is an effective analgesic measure. We studied the analgesic effect of TEAS by applying it alone after ureteroscopic lithotripsy, rather than applying it as a supplementary analgesic measure. Participants (n = 120) scheduled to undergo ureteroscopic holmium laser lithotripsy, were enrolled and randomly assigned into Group T (TEAS n = 60) and Group C (Control, n = 60). The participants in Group T were treated with TEAS for postoperative analgesia. TEAS were implemented on bilateral Shenyu (BL23) and Yinlingquan (SP9) at the time backward and the time at 4, 8, 12 h postoperatively. TEAS was re-implemented three times on the target acupoints for the next 2 days. When TEAS failed to meet the analgesic effect, the participants were given tramadol hydrochloride tablets of 100 mg. Participants of Group C were given tramadol hydrochloride tablets for postoperative analgesia. The primary outcome of VAS scores at the time backward (T), 4 h (T), 12 h (T), 24 h (T), 48 h (T) postoperatively and the amount of remedy for analgesic consumption within 48 h postoperatively were compared. The secondary outcome of adverse reactions and plasma concentrations of serotonin (5-HT) and substance P (SP) at T, T, T, T, T were detected, respectively. The VAS scores at T, T, T, T postoperatively in two groups were lower than T. Compared to group C, the VAS scores at T (3.68 ± 0.68 vs. 4.79 ± 0.82, P = 0.01), T (2.64 ± 0.72 vs. 3.92 ± 0.88, P = 0.03), T (2.21 ± 0.88 vs. 3.38 ± 0.74, P < 0.01) in Group T were lower, and total remedy of analgesic consumption was significantly lower (127.14 ± 28.46 vs. 415.27 ± 86.37, P < 0.01) within 48 h postoperatively. The plasma concentrations of 5-HT in Group T was lower than Group C at T (348.54 ± 138.49 vs. 418.69 ± 124.68, P = 0.03), T (324.28 ± 112.73 vs. 398.52 ± 114.53, P < 0.01), T (309.64 ± 129.09 vs. 388.46 ± 115.36, P = 0.04) postoperatively and concentrations of SP at T (59.38 ± 24.68 vs. 78.93 ± 26.32, P < 0.01), T (49.36 ± 25.55 vs. 66.49 ± 23.57, P = 0.02), T (42.19 ± 24.36 vs. 64.15 ± 28.16, P = 0.04), T (39.26 ± 19.88 vs. 54.64 ± 20.62, P = 0.02) postoperatively were also lower than Group C. Meanwhile, the occurrences of vertigo (6.7 vs. 18.3%, P < 0.01), nausea and vomiting (11.7 vs. 21.7%, P < 0.01), constipation (10.0 vs. 20.0%, P = 0.03) in Group T were also lower. Application of TEAS alone was associated with effective alleviation of postoperative pain, reduction of postoperative analgesics consumption, decrease of plasma concentration of algogenic substance and the incidence of adverse reactions after ureteroscopic lithotripsy.

Effects of transcutaneous electrical acupoint stimulation on perioperative immune function and postoperative analgesia in patients undergoing radical mastectomy: A randomized controlled trial

“…In the present study, TEAS in combination with low-dose opioids was selected for analgesia. The results suggested that patients in the TEAS group displayed significantly lower VAS scores at 12 and 24 h post-operation, as well as reduced consumption of PCA within 48 h post-surgery, indicating that TEAS displayed potent analgesic effects, which was consistent with a previous study (27). Therefore, TEAS might be associated with effective postoperative pain relief and lower analgesic consumption.…”

“…A constant electrical stimulation was applied for 30 min each time with a dense-and-disperse frequency of 2/100 Hz (26) via a HANS LH-202 electrical stimulator (Nanjing Jisheng Medical Technology Co., Ltd.). The optimal intensity was set to mild twitching of the surrounding muscle and individual maximum tolerance (5-10 mA for upper limbs; 10-30 mA for lower limbs) (27,28). The TEAS effect was confirmed by de qi sensation (27,29).…”

“…The optimal intensity was set to mild twitching of the surrounding muscle and individual maximum tolerance (5-10 mA for upper limbs; 10-30 mA for lower limbs) (27,28). The TEAS effect was confirmed by de qi sensation (27,29). Participants in the sham TEAS group underwent electrode attachment on the target acupoints without electronic stimulation.…”

Effects of Transcutaneous Electrical Acupoint Stimulation on Systemic Inflammatory Response Syndrome of Patients after Percutaneous Nephrolithotomy: A Randomized Controlled Trial

“…According to the theory of traditional Chinese medicine (TCM), acupuncture on BL23 contributes to reduce the pressure in the renal pelvis, relax the smooth muscle of the ureter, and reduce the local edema caused by ureteral stones. Our previous study suggested that TEAS on BL23 and SP9 helped to alleviate postoperative pain for patients after ureteroscopic lithotripsy [ 22 ]. In fact, inflammation response is one of the common causes for postoperative pain.…”

Comparative analysis of two laser wavelengths in the stimulation of acupuncture points for analgesic effects in an animal model

“…Laser acupuncture is defined as the stimulation of traditional acupuncture points with application of a low-intensity, nonthermal laser. Although it has been shown to be effective in treating various conditions, the mechanisms underlying its effects are not yet fully understood [25][26][27][28][29][30]. The low-power lasers used in acupoints provide light-based energy capable of producing photobiomodulation induction, which, by its turn, produces biochemical and isoelectric effects on local cells, providing an anti-inflammatory and analgesic effect.…”