Department of Anesthesiology, Guizhou Provincial People's Hospital, No. 83 Zhongshan Road Nanming district, Guiyang City, Guizhou Province, China.
Trials. 2020 Jan 8;21(1):43. doi: 10.1186/s13063-019-3892-4.
INTRODUCTION: 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. METHODS: Sixty 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%). CONCLUSION: The 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 REGISTRATION: ClinicalTrials.gov, NCT02619578. Registered on 2 December 2015. Trial registry name: https://clinicaltrials.gov.
简介：本研究旨在评估经皮穴位电刺激（TEAS）对妇科腹腔镜手术患者早期康复质量的影响。 方法：60 例行妇科腹腔镜手术的患者被随机分为 TEAS 组（TEAS 组）或对照组（Con 组）。TEAS 组在麻醉前接受 30 分钟刺激（12-15 mA，2/100 Hz），刺激穴位为百会（GV20）、迎香（EX-HN-3）、足三里（ST36）和内关（PC6）。Con 组患者贴上电极，但不接受刺激。使用包含 40 个项目的问卷评估康复质量，作为康复质量评分系统（QoR-40；最高得分为 200 分），分别在术前第 1 天（T0）、术后第 1 天（T1）和术后第 2 天（T2）进行评分；记录术后休息时 100mm 视觉模拟量表（VAS）评分、简易精神状态检查（MMSE）评分、恶心和呕吐的发生率、术后止痛药和止吐药的使用情况。 结果：两组患者 T0 时的 QoR-40 和 MMSE 评分无差异（QoR-40：197.50±2.57 vs. 195.83±5.17），（MMSE：26.83±2.74 vs. 27.53±2.88）。与 Con 组相比，TEAS 组 T1 和 T2 时的 QoR-40 和 MMSE 评分更高（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）。TEAS 组 T1 和 T2 的 VAS 评分较低（P<0.05）（T1，4.73±1.53 vs. 3.70±1.41；T2，2.30±0.95 vs. 1.83±0.88）；TEAS 组术后恶心和呕吐（PONV）、补救性止吐药和补救性镇痛药的发生率较低（P<0.05）（PONV：56.7% vs. 23.3%；补救性止吐药：53.3% vs. 23.3%；补救性镇痛药：80% vs. 43.3%）。 结论：使用 TEAS 可显著促进妇科腹腔镜手术患者的早期康复质量，提高 MMSE 评分，并降低疼痛、恶心和呕吐的发生率。 试验注册：ClinicalTrials.gov，NCT02619578。注册于 2015 年 12 月 2 日。试验注册名称：https://clinicaltrials.gov。
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