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

Rong Zhou,Zhengzuo Wan,Jinlin Shi,Jiangyong Gu,Hong Yu,Jianming Yu,Yanan Li,Bin Que,Jianhui Gan,Qing Tu

doi:10.1155/2021/5909956

Abstract

Purpose Transcutaneous electrical acupoint stimulation (TEAS) is widely used. However, no study evaluated TEAS on systemic inflammatory response syndrome (SIRS) of patients after percutaneous nephrolithotomy (PCNL). The study was to evaluate TEAS on SIRS of patients after PCNL. Methods 67 patients were enrolled and divided into group TEAS and group sham TEAS. Data were collected from 60 participants finally. In the study, TEAS or sham TEAS on bilateral Shenshu (BL23), Yinlingquan (SP9), Hegu (LI4), and Neiguan (PC6) was performed continuously throughout the procedure. The primary outcome included the incidence of systemic inflammatory response syndrome (SIRS) within 48 h after surgery. The secondary outcomes included the serum levels of inflammatory cytokines, hemodynamics changes, complications, and hospital stay after surgery. The serum levels of tumor necrosis factor- (TNF-) α and interleukin- (IL-) 6, mean arterial pressure (MAP), and heart rate (HR) at 30 min before anesthesia (T0), the time after surgery (T1), 24 h postoperation (T2), and 48 h postoperation (T3) were recorded. The consumption of analgesic during surgery was also recorded, as well as the complications and duration of hospital stay after PCNL. Results The incidence of SIRS in group TEAS was lower than group sham TEAS (30% vs. 6.67%, p=0.023). Compared with the sham TEAS group, both levels of TNF-α and IL-6 at T1, T2, and T3 were lower in the TEAS group (p < 0.05). The levels of MAP and HR in sham TEAS at T1, T2, and T3 were markedly higher than that in the TEAS group (p < 0.05). The total consumption of propofol and remifentanil during surgery in group TEAS was lower than that in the sham TEAS group. The incidence of hypotension, hypertension, emergence agitation, and postoperative nausea and vomiting (PONV) was also lower in group TEAS after PCNL (p < 0.05). Conclusions TEAS could effectively reduce the incidence of SIRS and inflammatory cytokines for patients who underwent PCNL. In addition, TEAS helped to maintain the hemodynamic stability and cut down the consumption of analgesics during PCNL, reducing the complications after PCNL.

Highlights

Percutaneous nephrolithotomy (PCNL) has the advantages of less trauma and faster recovery, which gradually becomes the first-line treatment for upper urinary calculi removal [1]
We enrolled 67 participants in the study. roughout the study, there were 2 surgeries cancelled in group Transcutaneous electrical acupoint stimulation (TEAS), as well as 1 in group sham TEAS
Compared with the sham TEAS group, both levels of tumor necrosis factor- (TNF-)α and IL-6 at T1, T2, and T3 were lower in the TEAS group (p < 0.05), indicating that TEAS inhibited the release of cytokines after PCNL (Figure 3)

Summary

Introduction

Percutaneous nephrolithotomy (PCNL) has the advantages of less trauma and faster recovery, which gradually becomes the first-line treatment for upper urinary calculi removal [1]. Perioperative inflammatory response and even the systemic inflammatory response syndrome (SIRS) may occur after this procedure. A study reported the incidence of 27.6% fever after PCNL, 1.5–37% of whom developed SIRS [2, 3]. The procedure might spread the local urinary tract infections and pathogenic factors, which cause excessive activation of inflammatory cells, resulting in excessive release of various inflammatory cytokines and systemic hyperinflammatory reactions [4]. A previous study had shown that TEAS could effectively reduce the consumption of remifentanil and the incidence of postoperative vertigo and itching after general anesthesia [6].

Materials and Methods

Results

Discussion

Conclusion