Abstract
IntroductionIn current study we assessed the effect of transcutaneous electrical acupoint stimulation (TEAS) on the quality of early recovery in patients undergoing gynecological laparoscopic surgery.MethodsSixty patients undergoing gynecological laparoscopic surgery were randomly assigned to TEAS (TEAS group) or control group (Con group). TEAS consisted of 30 min of stimulation (12–15 mA, 2/100 Hz) at the acupoints of Baihui (GV20), Yingtang (EX-HN-3), Zusanli (ST36) and Neiguan (PC6) before anesthesia. The patients in the Con group had the electrodes applied, but received no stimulation. Quality of recovery was assessed using a 40-item questionnaire as a measure of quality of recovery (QoR-40; maximum score 200) scoring system performed on preoperative day 1 (T0), postoperative day 1 (T1) and postoperative day 2 (T2); 100-mm visual analogue scale (VAS) scores at rest, mini-mental state examination (MMSE) scores, the incidence of nausea and vomiting, postoperative pain medications, and antiemetics were also recorded. Results: QoR-40 and MMSE scores of T0 showed no difference between two groups (QoR-40: 197.50 ± 2.57 vs. 195.83 ± 5.17), (MMSE: 26.83 ± 2.74 vs. 27.53 ± 2.88). Compared with the Con group, QoR-40 and MMSE scores of T1 and T2 were higher in the TEAS group (P < 0.05) (QoR-40: T1, 166.07 ± 8.44 vs. 175.33 ± 9.66; T2, 187.73 ± 5.47 vs. 191.40 ± 5.74), (MMSE: T1, 24.60 ± 2.35 vs. 26.10 ± 2.78; T2, 26.53 ± 2.94 vs. 27.83 ± 2.73). VAS scores of T1 and T2 were lower (P < 0.05) in the TEAS group (T1, 4.73 ± 1.53 vs. 3.70 ± 1.41; T2, 2.30 ± 0.95 vs. 1.83 ± 0.88); the incidence of postoperative nausea and vomiting (PONV), remedial antiemetics and remedial analgesia was lower in the TEAS group (P < 0.05) (PONV: 56.7% vs. 23.3%; incidence of remedial antiemetics: 53.3% vs. 23.3%; incidence of remedial analgesia: 80% vs. 43.3%).ConclusionThe use of TEAS significantly promoted the quality of early recovery, improved MMSE scores and reduced the incidence of pain, nausea and vomiting in patients undergoing gynecological laparoscopic surgery.Trial registrationClinicalTrials.gov, NCT02619578. Registered on 2 December 2015.Trial registry name: https://clinicaltrials.gov
Highlights
In current study we assessed the effect of transcutaneous electrical acupoint stimulation (TEAS) on the quality of early recovery in patients undergoing gynecological laparoscopic surgery
Global scores at T1 and T2 were significantly higher in the Transcutaneous electrical acupoint stimulation (TEAS) group (P = 0.040 and P = 0.015 for global Quality of Recovery-40 (QoR-40) at T1 and T2, respectively); when T0 was used as a covariate for a repeated measures model of T1 and T2, the significances for the interaction of group and time course were 0.003 and 0.036, respectively, indicating better quality of recovery with TEAS treatment (Fig. 4)
There were no significant differences in the baseline (T0) Mini-Mental State Examination (MMSE) score for cognitive functioning in the two groups; the scores were significantly lower in the TEAS group compared with the Con group (P = 0.048 and P = 0.02 for T1 and T2, respectively); when T0 was used as a covariate for a repeated measures model of T1 and T2, the significances for the interaction of group and time course were 0.007 and 0.046, respectively (Fig. 5)
Summary
In current study we assessed the effect of transcutaneous electrical acupoint stimulation (TEAS) on the quality of early recovery in patients undergoing gynecological laparoscopic surgery. During the past four decades, gynecologic laparoscopy has evolved from a limited method to an advanced operative approach that frequently serves as a substitute for laparotomy. Multiple studies have demonstrated that TEAS could reduce the use of intra-operative opioid drugs and the incidence of postoperative nausea and vomiting (PONV), and improve postoperative cognitive function [7, 8]. Whether TEAS could improve the quality of early recovery after gynecologic laparoscopy is unknown. In this study we investigated the effects of TEAS at the acupoints of Baihui (GV20), Yingtang (EX-HN3), Zusanli (ST36) and Neiguan (PC6) on the quality of early recovery in patients undergoing gynecological laparoscopic surgery
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