Transcutaneous Electrical Acupoint Stimulation Improves Immunological Function During the Perioperative Period in Patients With Non-Small Cell Lung Cancer Undergoing Video-Assisted Thoracic Surgical Lobectomy

Abstract

The immunological function of patients with malignant tumors may be suppressed during the perioperative period. However, details on the effects of transcutaneous electrical acupoint stimulation (TEAS) on immunological function are relatively lacking. We designed this study to examine the effects of TEAS on the immunological function of patients with non-small cell lung cancer (NSCLC) during the perioperative period. Participants (n = 144) were enrolled and randomly assigned into group TEAS or group sham TEAS. TEAS on bilateral Feishu (BL13), Hegu (L14), and Zusanli (ST36) was performed continuously throughout the procedure. The primary outcome was the quantities of natural killer (NK) cells at 30 minutes before induction (T0), 5 minutes after intubation (T1), at the beginning of the operation (T2), at the beginning of the lobectomy (T3), at the beginning of the lymphadenectomy (T4), and immediately after extubation (T5). The secondary outcomes were the serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) at T0 to T5, the mean arterial pressure (MAP) and heart rate (HR), the intraoperative consumption of propofol and remifentanil, the incidence of hypoxemia, postoperative nausea and vomiting (PONV), and the length of hospital stay. The quantities of NK cells were decreased in group sham TEAS after intubation compared to that in group TEAS, while the quantities of NK cells in group TEAS were similar at T0 to T5. Meanwhile, the quantities of NK cells in group sham TEAS at T1 (P = .012), T2 (P < .001), T3 (P = .027), T4 (P = .045), and T5 (P = .021) were lower than those in group TEAS. In group TEAS, the serum levels of TNF-α were lower at T1 to T5, while the levels of IL-6 were lower at T2 to T5. Furthermore, the intraoperative MAP and HR were more stable, the total propofol and remifentanil consumptions were lower, and the length of hospital stay was shorter than those in group sham TEAS. The application of TEAS can effectively reverse the decrease in NK cells, decrease the serum levels of TNF-α and IL-6, maintain hemodynamic stability during the perioperative period, decrease the consumption of propofol and remifentanil, and shorten the length of the hospital stay.

Systematic Review and Meta-analysis of Nonpharmacological Interventions for Lung Cancer Fatigue

“…Compared with acupuncture, acupressure is simpler and safer; with little training, patients themselves and their caregivers can use it. TEAS is also a type of acupuncture that uses electrodes placed on the surface instead of acupuncture needles to add an electrical stimulation pulse to the target acupoints (Tu et al, 2018). Consistent with previous studies (Grant et al, 2015;, our results indicated that acupuncture and acupressure may be efficient methods for relieving fatigue among lung cancer patients.…”

Use of transcutaneous electrical acupoint stimulation in pulmonary surgery for patients with tuberculosis

“…Presently, most experimental results [15] , [16] suggest that TEAS can reduce postoperative immunosuppression and have a positive regulatory effect on immune function, especially cellular immune function, but the time points of each experiment are different. In this study, there was a significant decline in the levels of CD3 + , CD4 + , CD4 + /CD8 + , and NK cells between the two groups preoperatively and a significant rise in CD8 + level.…”

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

“…Moreover, EA at acupoint ST36 alone in mice may ameliorate inflammation and modulate immune function in collagen-induced arthritis ( 50 ). EA at acupoint ST36 has been revealed to be beneficial for preserving immune function and improving postoperative recovery ( 17 , 29 ). Consequently, PC-6, LI-4 and ST-36 acupoints were investigated in the present study.…”

“…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.…”