Sixty patients scheduled for laparoscopic cholecystectomy (LC) were randomized to TN (n = 30) and sham-TN (n = 30). TN was performed via acupoints ST36 and PC6 for 30 min twice daily from 24 hours before surgery to 72 hours after surgery. Sham-TN was performed using the same parameters at nonacupoints.
Sample Count
60
Age
18-65
Control
Sham
sham-TN(n=30)
Experiment
TN(n=30)
Indicator
Dyspepsia symptoms scoreVisual analog scale(VAS)Time of first defecationTime of first flatusTime to resuming diet were notedElectrocardiogram(ECG)Electrogastrogram(EGG)IL-6Norepinephrine(NE)
Stimulation Method
TEAS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
SNM-FDC01
Ningbo Maida Medical Device, Inc., Ningbo, China
25 Hz(ST36);100 Hz(PC6)
trains of pulses
2-10 mA
30 min
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
-
-
-
Description A watch-size digital stimulator (SNM-FDC01, Ningbo Maida Medical Device, Inc., Ningbo, China) was used to deliver trains of pulses. The stimulation parameters for ST36 stimulator were set at 2 sec on and 3 sec off, pulse width of 0.5 msec, pulse frequency of 25 Hz, and amplitude of 2-10 mA (at the maximum level tolerated by the subject) based on previous studies; for PC6, stimulator was set at 0.1 sec on and 0.4 sec off, pulse width of 0.5 msec, pulse frequency of 100 Hz, and amplitude of 2-10 mA, which were shown to improve nausea and vomiting, and visceral pain. The bilateral stimulation TN treatment was given for half hour, twice daily (once on the day of surgery), lasting for 4 days.
Anesthesia Method
GA
Clinical Trial Type
randomly
Contraindications
Allergic to skin preparation
Effector
1） Compared to sham-TN，TN shortened time to first flatulence （38.9 ± 4.0 vs. 24.9 ± 2.4 hour， p = 0.004） and time to defecation (63.1±4.5 vs. 42.5±3.1 hour, p < 0.001).2)Compared to sham-TN,TN increased the percentage of normal pace making activity （66.2±2.2 vs.73.8±2.3%，p = 0.018）. 3）TN enhanced vagal activity. Compared to that 24 hours before sur- gery，surgery decreased vagal activity（HF）（0.41± 0.02 vs. 0.34± 0.02，p = 0.043）3 hours after the operation. Compared to sham-TN,TN increased HF (0.45± 0.02 vs. 0.52± 0.02, p = 0.045) 72 hours after the operation.Further, HF was negatively cor related with time to defecation and serum norepinephrine. 4）Surgery increased serum IL-6 （1.1 ± 0.1 before surgery vs. 2.9 ± 0.7 pg/mL, p = 0.041) 72 hours after the operation, which was reduced to baseline by TN (0.9± 0.1). In conclusion, the proposed needleless TN accelerates postoperative recovery after LC, possibly mediated via the autonomic and immune-cytokine mechanisms. Needleless and self-administrable TN may be an easy-to-implement and low-cost complementary therapy for postoperative recovery.
Needleless Transcutaneous Neuromodulation Accelerates Postoperative Recovery Mediated via Autonomic and Immuno-Cytokine Mechanisms in Patients With Cholecystolithiasis.
Abstract
BACKGROUND: Postsurgical gastrointestinal disturbance is clinically characterized by the delayed passage of flatus and stool, delayed resumption of oral feeding, dyspepsia symptoms, and postsurgical pain. This study was designed 1) to evaluate the effects of needleless transcutaneous neuromodulation (TN) on postoperative recovery; 2) to investigate mechanisms of the TN involving autonomic functions in postoperative patients after removal of the gallbladder. METHODS: Sixty patients scheduled for laparoscopic cholecystectomy (LC) were randomized to TN (n = 30) and sham-TN (n = 30). TN was performed via acupoints ST36 and PC6 for 30 min twice daily from 24 hours before surgery to 72 hours after surgery. Sham-TN was performed using the same parameters at nonacupoints. RESULTS: 1) Compared to sham-TN, TN shortened time to first flatulence (38.9 +/- 4.0 vs. 24.9 +/- 2.4 hour, p = 0.004) and time to defecation (63.1 +/- 4.5 vs. 42.5 +/- 3.1 hour, p < 0.001). 2) Compared to sham-TN, TN increased the percentage of normal pace-making activity (66.2 +/- 2.2 vs. 73.8 +/- 2.3%, p = 0.018). 3) TN enhanced vagal activity. Compared to that 24 hours before surgery, surgery decreased vagal activity (HF) (0.41 +/- 0.02 vs. 0.34 +/- 0.02, p = 0.043) 3 hours after the operation. Compared to sham-TN, TN increased HF (0.45 +/- 0.02 vs. 0.52 +/- 0.02, p = 0.045) 72 hours after the operation. Further, HF was negatively correlated with time to defecation and serum norepinephrine. 4) Surgery increased serum IL-6 (1.1 +/- 0.1 before surgery vs. 2.9 +/- 0.7 pg/mL, p = 0.041) 72 hours after the operation, which was reduced to baseline by TN (0.9 +/- 0.1). CONCLUSIONS: In conclusion, the proposed needleless TN accelerates postoperative recovery after LC, possibly mediated via the autonomic and immune-cytokine mechanisms. Needleless and self-administrable TN may be an easy-to-implement and low-cost complementary therapy for postoperative recovery."
Souce
Neuromodulation. 2019 Jul;22(5):546-554. doi: 10.1111/ner.12856. Epub 2018 Oct 1.
