Description bilateral Hegu (LI4), Neiguan (PC6) and Zusanli (ST36)
Experimental Description
A total of 65 patients were enrolled and allocated to either receive TEAS or sham TEAS.
Sample Count
65
Age
20-65
Control
Sham
sham TEAS(n=32)
Experiment
TEAS(n=33)
Indicator
Visual analog scale(VAS)IL-2IL-4IFN-γIL-2/IL-4 ratioCumulative time of rescue analgesia within 48h post-surgeryPostoperative Nausea and Vomiting(PONV)Pruritus
Auxiliary Medication
The PCA pump bolus and the total consumption of opioids.
The PCA consisted of 1.5 µg/kg sufentanil (cat. no. 81A09131; Yichang Humanwell Pharmaceutical Co., Ltd.), diluted to 150 ml with normal saline. The basal infusion rate was set to 2 ml/h, with a bolus dose of 0.5 ml and a lockout interval of 15 min.
Stimulation Method
TEAS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
HANS LH-202
Nanjing Jisheng Medical Technology Co., Ltd., Nanjing, Jiangsu, China
2/100 Hz
sparse-dense wave
5-10 mA (upper limbs);10-30 mA (lower limbs)
30 min
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
-
-
-
Description TEAS was implemented on bilateral Hegu (LI4), Neiguan (PC6) and Zusanli (ST36) acupoints simultaneously for 30 min before induction of anesthesia at 4 and 12 h post-operation.
A constant electrical stimulation was applied for 30 min each time with a dense-and-disperse frequency of 2/100 Hz via a HANS LH-202 electrical stimulator (Nanjing Jisheng Medical Technology Co., Ltd.). 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).
Anesthesia Method
GA
Clinical Trial Type
random
Adverse Effects
Compared with the sham TEAS group, the incidences of PONV and headache were significantly lower in the TEAS group. No significant differences between the two groups were detected regarding the incidence of pruritis and dizziness (Table II).
Contraindications
Puncture site infection or systemic infection
Effector
Compared with the sham TEAS group, postoperative VAS scores at T2 and T3, the total consumption of opioids in the patient-controlled analgesia (PCA) pump, pressing times of the PCA pump and the incidences of PONV and headache were significantly lower in the TEAS group. The serum levels of IFN-γ at T3 and T4, and the serum levels of IL-2 and the IL-2/IL-4 ratio at T2, T3 and T4 were higher in the TEAS group compared with the sham TEAS group. By contrast, the serum levels of IL-4 were lower at T2, T3 and T4 in the TEAS group compared with the sham TEAS group. The results indicated that TEAS could improve postoperative analgesia, reduce postoperative consumption of opioids and alleviate postoperative side effects. Simultaneously, TEAS was able to reverse decreased serum levels of IL-2 and IFN-γ, reduce the level of IL-4 and restore the balance of Th1/Th2, thereby partially attenuating perioperative immune function depression in patients with breast cancer.
Effects of transcutaneous electrical acupoint stimulation on perioperative immune function and postoperative analgesia in patients undergoing radical mastectomy: A randomized controlled trial.
Abstract
Radical mastectomy may lead to suppression of cellular immune function in patients with malignant tumors. Transcutaneous electrical acupoint stimulation (TEAS) is widely used in clinical practice. However, there have been relatively few studies on the effects of TEAS on postoperative analgesia and immune function. The present study aimed to evaluate the effects of TAES on postoperative pain and immune function in patients undergoing radical mastectomy. A total of 65 patients were enrolled and allocated to either receive TEAS or sham TEAS. TEAS was implemented on bilateral Hegu (LI4), Neiguan (PC6) and Zusanli (ST36) acupoints simultaneously for 30 min before induction of anesthesia at 4 and 12 h post-operation. The primary outcomes included visual analogue scale (VAS) scores at 4 h (T(1)), 12 h T(2)), 24 h (T(3)) and 48 h (T(4)) post-operation, and serum levels of IL-2, IL-4, IFN-gamma and the IL-2/IL-4 ratio at 30 min before TEAS (T(0)), T(1), T(2), T(3) and T(4). Secondary outcomes included the cumulative time of rescue analgesia within 48 h post-surgery, as well as the incidence of postoperative nausea and vomiting (PONV) and pruritus. Compared with the sham TEAS group, postoperative VAS scores at T(2) and T(3), the total consumption of opioids in the patient-controlled analgesia (PCA) pump, pressing times of the PCA pump and the incidences of PONV and headache were significantly lower in the TEAS group. The serum levels of IFN-gamma at T(3) and T(4), and the serum levels of IL-2 and the IL-2/IL-4 ratio at T(2), T(3) and T(4) were higher in the TEAS group compared with the sham TEAS group. By contrast, the serum levels of IL-4 were lower at T(2), T(3) and T(4) in the TEAS group compared with the sham TEAS group. The results indicated that TEAS could improve postoperative analgesia, reduce postoperative consumption of opioids and alleviate postoperative side effects. Simultaneously, TEAS was able to reverse decreased serum levels of IL-2 and IFN-gamma, reduce the level of IL-4 and restore the balance of Th1/Th2, thereby partially attenuating perioperative immune function depression in patients with breast cancer. The current trial was registered prior to participant enrollment at www.chictr.org.cn (Clinical Trial no. ChiCTR1800017768)."
