Ninety patients (age ≥ 60 years) undergoing laparoscopic gastric cancer surgery were randomly divided into general anesthesia group (group G), TAPB group (group NG), and TEAS combined with TAPB group (group NTG).
Sample Count
90
Age
≥60
Control
Std
general anesthesia group(group G)(n=30);TAPB group (group NG)(n=30)
Experiment
TEAS combined with TAPB group (group NTG)(n=30)
Indicator
QoR-15T lymphocyte subsetsAnesthetic dosageExtubation timeVisual analog scale(VAS)Time of first postoperative ambulationTime of first flatusPostoperative adverse events
Auxiliary Medication
Patients were intravenously administered midazolam (0.04 mg/kg), etomidate (0.3 mg/kg), sufentanil (0.3 μg/kg), and rocuronium (1 mg/kg). Anesthesia was maintained with a target-controlled infusion of propofol and remifentanil. The propofol and remifentanil concentrations were adjusted to hemodynamic index and BIS 40–60. Prophylactic flurbiprofen axetil (50 mg) and azasetron (10 mg) were administered for postoperative pain and PONV. The same surgeon performed all procedures. Patients were transferred to the post-anesthesia care unit (PACU) after extubation in the operation room. All patients received patient-controlled intravenous analgesia (PCIA) for 2 days and which contained 100 mL of 0.5 μg/mL sufentanil. The PCIA was set as follows: single-dose 2 mL, lock time 15 min, and no background infusion and continuous infusion. If the movement VAS score was greater than 4 points, flurbiprofen axetil 50 mg was intravenously injected as salvage analgesia.
Stimulation Method
TEAS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
Hwato SDZ-V
Suzhou Medical Technology Co. Ltd., Suzhou, China
without actual electric stimuli(group G,group NG);2/100 Hz(group NTG)
dense wave(group NTG)
mild twitching of the surrounding muscle up to the maximum tolerated by the individual
30 minutes before anesthesia administration until the end of the surgery
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
-
-
-
Description The NTG group was provided with a 2/100 Hz density wave and actual electric stimuli. The optimal intensity was set to mild twitching of the surrounding muscle up to the maximum tolerated by the individual.
Anesthesia Method
AAA
Clinical Trial Type
random
Contraindications
Swelling, infection, or ulceration at the site of TEAS
Effector
The combination of TEAS and TAPB ameliorated postoperative pain, improved immune and gastrointestinal function, reduced the incidence of PONV, and effectively promoted postoperative recovery in elderly patients undergoing laparoscopic gastric cancer surgery.
Effect of Transcutaneous Electrical Acupoint Stimulation Combined with Transversus Abdominis Plane Block on Postoperative Recovery in Elderly Patients Undergoing Laparoscopic Gastric Cancer Surgery: A Randomized Controlled Trial.
Abstract
INTRODUCTION: This study assessed the influence of transcutaneous electrical acupoint stimulation (TEAS) combined with transversus abdominis plane block (TAPB) on the recovery of elderly patients undergoing laparoscopic gastric cancer surgery. METHODS: Ninety patients (age >/= 60 years) undergoing laparoscopic gastric cancer surgery were randomly divided into general anesthesia group (group G), TAPB group (group NG), and TEAS combined with TAPB group (group NTG). Patients in the NTG group received TEAS at PC6, LI4, and ST36 acupoints and TAPB. Patients in the NG group received TAPB. The quality of recovery (QoR) was assessed using the QoR-15 questionnaire. The percentages of T lymphocyte subsets were determined. Consumption of anesthetics, extubation time, visual analog scale (VAS) scores, time of first postoperative ambulation and flatus, and postoperative adverse events were also recorded. RESULTS: QoR-15 scores on postoperative day (POD) 3 and POD 7 were higher in the NTG group than in the G and NG groups (P < 0.05). On POD 1 and POD 3, the percentages of CD3(+) and CD4(+) T cells and the CD4(+)/CD8(+) ratio were higher and the percentage of CD8(+) T cells was lower in the NTG group than in the G and NG groups (P < 0.05). Remifentanil consumption, and the incidence of postoperative nausea and vomiting (PONV) were lower and extubation time and time of first postoperative flatus were shorter in the NTG group than in the G and NG groups (P < 0.05). Compared with the G group, the VAS scores on POD 1 were lower in the NG group and those on POD 2 were lower in the NTG group (P < 0.05). CONCLUSION: The combination of TEAS and TAPB ameliorated postoperative pain, improved immune and gastrointestinal function, reduced the incidence of PONV, and effectively promoted postoperative recovery in elderly patients undergoing laparoscopic gastric cancer surgery. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2100042119)."
