Transcutaneous electrical acupoint stimulation for postoperative cognitive dysfunction in geriatric patients with gastrointestinal tumor: a randomized controlled trial

Abstract

Background This study aimed to evaluate the effect of perioperative transcutaneous electrical acupoint stimulation (TEAS) on postoperative cognitive dysfunction (POCD) in older patients who were diagnosed with gastrointestinal tumor and received radical resection of gastrointestinal tumors under general anesthesia. Methods A total of 68 patients who received radical resection of gastrointestinal tumors under general anesthesia were randomly divided into two groups. TEAS group patients received TEAS treatment. The treatment time was 30 min before the induction of anesthesia until the end of the surgery, 1 day before operation and from the first day to the third day after the operation. Except on the day of surgery, we treated the patients for 30 min once a day. In the sham TEAS group, the electronic stimulation was not applied and the treatment was the same as the TEAS group. The primary outcome was perioperative cognition evaluated by the Mini-Mental State Examination (MMSE) and secondary outcomes were the perioperative level of interleukin-6 (IL-6), S100 calcium-binding protein β (S100β), and C-reactive protein (CRP). Results The postoperative score of MMSE, orientation, memory, and short-term recall in the sham TEAS group was significantly lower than the preoperative and TEAS group (P < 0.05). The incidence of POCD in the TEAS group (21.88%) was lower than those in the sham TEAS group (40.63%). S100β, IL-6, and CRP in the TEAS group were significantly lower than those in the sham TEAS group on the third day after the operation (P< 0.05). Postoperative S100β, IL-6, and CRP in two groups were significantly higher than those before operation except for S100β on the third day after the operation in the TEAS group (P < 0.05). Conclusions Perioperative TEAS treatment reduced the postoperative inflammatory response and increased the postoperative cognitive function score and decrease the incidence of POCD in geriatric patients with gastrointestinal tumor. Trial registration ClinicalTrials.gov NCT04606888. Registered on 27 October 2020. https://register.clinicaltrials.gov.

Transcutaneous electrical acupoint stimulation for reducing cognitive dysfunction in lumbar spine surgery: A randomized, controlled trail

“…Whether different electrical stimulation durations have different effects on improving POCD is still uncertain. Some studies showed that continuous stimulation from 30 min before surgery to the end of surgery can improve postoperative POCD in elderly patients and play a protective role in neurological function ( Liu et al, 2021 ; Xi et al, 2021 ; Wei et al, 2022 ). Generally, TEAS intervention is used in the perioperative period, starting more than 30 min before the operation, to reduce the patient’s pain response when the surgeon cuts the skin.…”

Effect of Somatosensory Interaction Transcutaneous Electrical Acupoint Stimulation on Cancer-related Fatigue and Immunity

“…The combination of the acupoints above can activate Qi and blood circulation and regulate viscera functions to balance the qi and blood, dredge meridians and qi activity, strengthen the body resistance to eliminate pathogenic factors, and improve immunity and fatigue resistance. [41][42][43] TEAS needs to be manually operated step by step. It was difficult for the discharged patients to operate this method.…”

“…The combination of these 2 acupoints, together with Zhongwan, can reinforce qi, nourish blood, and invigorate the spleen and stomach; Taixi is the source acupoint of the kidney meridian which can nourish the kidney and yin and supply vital essence and marrow. The combination of the acupoints above can activate Qi and blood circulation and regulate viscera functions to balance the qi and blood, dredge meridians and qi activity, strengthen the body resistance to eliminate pathogenic factors, and improve immunity and fatigue resistance 41–43…”

Effect of Subanesthetic Dose of Esketamine on Perioperative Neurocognitive Disorders in Elderly Undergoing Gastrointestinal Surgery: A Randomized Controlled Trial

“…According to previous reports, the incidence of POCD in geriatric patients with gastrointestinal tumors is 40%. 37 The pilot study showed that esketamine administration could reduce the incidence of PND by 30%. Given a power of 85% and a significance level of 5%, the sample size was determined to be 66, with 33 subjects in each arm using a 1:1 ratio for the groups.…”