Electroacupuncture for the prevention of postoperative gastrointestinal dysfunction in participants undergoing vascular laparotomy under general anesthesia: a randomized controlled trial

Abstract

BackgroundPostoperative gastrointestinal dysfunction (PGD) is a common complication following laparotomy under general anesthesia (GA). Abdominal distension occurs in 8–28% of surgeries within 24 h postoperatively. The present study aimed to analyze the efficacy of electroacupuncture (EA) for the prevention of PGD by applying preoperative EA stimulation of PC6 (Neiguan), ST36 (Zusanli), and ST37 (Shangjuxv) bilaterally twice within 24 h prior to surgery, compared with no acupuncture treatment.MethodsThe study participants were assessed and selected from participants undergoing vascular laparotomy under GA at the Liver and Vascular Surgery Unit in West China Hospital of Sichuan University. The selected participants were randomly allocated to two groups: routine-treatment (RT) and EA group receiving EA at PC6, ST36, and ST37. A computer-generated list of random numbers was used to determine the allocation of the participants, with numbered opaque sealed envelopes containing the randomization schedule. Eligible participants were all adults aged 18 years or above who were scheduled to undergo vascular laparotomy under GA within 24 h and had no history of EA treatment. The exclusion criteria included participants with serious systemic disease and history of EA treatment. While the RT group received standard treatments, the EA group received additional EA treatments. During each treatment session, EA stimulation was performed for a duration of 20 min at a frequency of 15 Hz with a continuous wave. All such participants received two EA treatments within 24 h before surgery. The outcomes were measured in three metrics: incidence and degree of abdominal distension; first times of flatus and defecation; and duration of hospitalization.ResultsForty-three participants were recruited, of whom 42 participants successfully completed the study. Each group contained 21 participants. The incidence of abdominal distension (42.8, 76.2%) and degree of abdominal distension were significantly reduced in the EA group (P = 0.03 and P = 0.03, respectively). In comparisons of the first times of flatus (3.05 ± 0.58, 3.29 ± 0.42 days) and defecation (2.81 ± 0.51, 3.20 ± 0.55 days) and duration of hospitalization (5.33 ± 0.68, 5.75 ± 0.66 days), the EA group was superior to the RT group to some extent (P = 0.13, P = 0.02, and P = 0.04, respectively).ConclusionsPreoperative EA at PC6, ST36, and ST37 might be useful for preventing PGD, thereby improving gastrointestinal function recovery. Trial registration This study is registered with the Chinese Clinical Trial Registry: ChiCTR-TRC-13003649Electronic supplementary materialThe online version of this article (doi:10.1186/s13020-016-0122-9) contains supplementary material, which is available to authorized users.

Electro-acupuncture attenuates inflammatory responses and intraabdominal pressure in septic patients

“…Preoperative EA at neiguan (PC6), ST36, and ST37 might be useful for preventing postoperative gastrointestinal dysfunction, thereby improving gastrointestinal function recovery. [ 32 ] In our study, ST36-ST37 were only selected and we found that EA at ST36-ST37 not only attenuated inflammatory responses but also reduced IAP. Therefore, EA at ST36-ST37 is convenient, effective, and feasible in ICU.…”

Efficacy of electro-acupuncture for gastrointestinal motility after colorectal cancer surgery: study protocol for a randomized controlled trial

“…Some RCTs [20,[27][28] have shown that EA on these acupoints can shorten the time of first flatus and defecation and can reduce the length of hospital stay. However, the number of cases in these studies is small, and the quality of research is not high.…”

“…Similar outcomes have been applied in previous studies on gastrointestinal dysfunction, such as the time to the first passage of flatus, the time of the first defecation, visual analogue scale (VAS), quality of life [4,18] , and the length of hospital stay [19][20][21] . Thus, we will adopt these outcomes in this study due to their wide application.…”

Perioperative acupuncture medicine

“… [56] A randomized, controlled, clinical trial confirmed that in the liver and vascular surgery, electroacupuncture at Zusanli and Xiaxu preoperatively was significantly improved in postoperative first ventilation, defecation, and hospital stay. [57] It was found that electroacupuncture at Zusanli could effectively improve postoperative intestinal obstruction and shorten the recovery time by measuring the intestinal motility, c-kit and P2X7 mRNA levels of rats at different time points during the modeling, which may be related to the increase of the content of mesenchymal cells in the intestinal myenteric plexus. [58] The effect of acupuncture at Sanyinjiao, Zusanli, Shuidao, and Shenque on day 15 after radical hysterectomy on postoperative urinary retention was assessed.…”