Forty-two patients (33 male, age: 69.5±1.5 years) scheduled for abdominal surgical removal of gastrointestinal cancers were randomized to TEA (n=21) and sham-TEA (n=21). TEA was performed via acupoints ST36 and PC6 1h twice daily from the postoperative day (POD) 1 to day 3. Sham-TEA was performed at non-acupoints.
Sample Count
42
Age
>18
Control
Sham
sham-TEA(n=21)
Experiment
TEA(n=21)
Indicator
Visual analog scale(VAS)Time of first defecationTime to resume dietTime of first flatusTime to resume dietThe length of the postoperative hospital stayElectrocardiogram(ECG)IL-6Norepinephrine(NE)TNF-αIL-1β
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
-
2-10mA (at the maximum level tolerated by the subject)
1 h
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
-
-
-
Description Each pair of electrodes were connected to a watch-size digital stimulator (SNM-FDC01, Ningbo Maida Medical Device Inc., Ningbo, China). The stimulation parameters for both stimulators were set at 2s on and 3s off, pulse width of 0.5ms, pulse frequency of 25Hz and amplitude of 2-10mA (at the maximum level tolerated by the subject) based on previous studies. The TEA treatment was given for 1 h, twice daily (9-10 a.m. and 4-5 p.m.), lasting for 3 days.
Anesthesia Method
GA
Clinical Trial Type
randomly
Contraindications
Allergic to skin preparation
Effector
(1) TEA improved major postoperative symptoms by about 30%, including a reduction in time to defecation by 31.7% (P<0.01 vs. sham-TEA), time to rst atus by 35.9% (P<0.001), time to ambulation by 42.8% (P<0.01), time to resuming diet by 26.5% (P<0.01) and hospital stay by 30% (P<0.05) as well as pain score by 50% (P<0.01). (2) TEA signi cantly increased vagal activity (P<0.001) and decreased sympathetic activity on POD 4 (P<0.001) compared with POD1 as well as the serum level of NE (P<0.05). (3) The vagal activity, high frequency assessed from the spectral analysis of heart rate variability, was negatively correlated with time to resuming diet, whereas the sympathetic measurement, serum norepinephrine was positively correlated with time to resuming diet and time to atus. (4) TEA but not sham-TEA decreased TNF-α by 17.4% from POD 1 to POD 4. (5) TEA was an independent predictor of a shorter hospital stay. Needleless TEA improves major postoperative symptoms by enhancing vagal and suppressing sympathetic activities.
Needleless Transcutaneous Electrical Acustimulation: A Pilot Study Evaluating Improvement in Post-Operative Recovery.
Abstract
BACKGROUND: Functional gastrointestinal disturbance occurs after abdominal surgeries and could last for an extended period of time in some cases. This study was designed (1) to evaluate the effects of needleless transcutaneous electrical acustimulation (TEA) on postoperative recovery, and (2) to investigate the mechanisms involving autonomic function in postoperative patients after removal of gastrointestinal cancers. METHODS: Forty-two patients (33 male, age: 69.5 +/- 1.5 years) scheduled for abdominal surgical removal of gastrointestinal cancers were randomized to TEA (n = 21) and sham-TEA (n = 21). TEA was performed via acupoints ST36 and PC6 1 h twice daily from the postoperative day (POD) 1 to day 3. Sham-TEA was performed at non-acupoints. RESULTS: (1) TEA improved major postoperative symptoms by about 30%, including a reduction in time to defecation by 31.7% (P < 0.01 vs. sham-TEA), time to first flatus by 35.9% (P < 0.001), time to ambulation by 42.8% (P < 0.01), time to resuming diet by 26.5% (P < 0.01) and hospital stay by 30% (P < 0.05) as well as pain score by 50% (P < 0.01). (2) TEA significantly increased vagal activity (P < 0.001) and decreased sympathetic activity on POD 4 (P < 0.001) compared with POD 1 as well as the serum level of NE (P < 0.05). (3) The vagal activity, high frequency assessed from the spectral analysis of heart rate variability, was negatively correlated with time to resuming diet, whereas the sympathetic measurement, serum norepinephrine was positively correlated with time to resuming diet and time to flatus. (4) TEA but not sham-TEA decreased TNF-alpha by 17.4% from POD 1 to POD 4. (5) TEA was an independent predictor of a shorter hospital stay. CONCLUSIONS: Needleless TEA improves major postoperative symptoms by enhancing vagal and suppressing sympathetic activities."
Souce
Am J Gastroenterol. 2018 Jul;113(7):1026-1035. doi: 10.1038/s41395-018-0156-y. Epub 2018 Jun 21.
