Song Bijia, Chang Yuanyuan, Li Yang, Zhu Junchao
Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
Department of Anesthesiology, Friendship Hospital of Capital Medical University, Beijing, People's Republic of China.
Nat Sci Sleep. 2020 Oct 27;12:809-819. doi: 10.2147/NSS.S270739. eCollection 2020.
Postoperative sleep disturbances have serious adverse effects on postoperative outcomes. Our paper aimed to observe the effect of using transcutaneous electrical acupoint stimulation (TEAS) on sleep quality and complications after surgery in patients undergoing selective video-assisted thoracoscopic surgery.
Eighty-five patients were divided into the TEAS group or the control group randomly. Thirty minutes of TEAS treatment was performed on TEAS group at the following time points: the first night before surgery, at the end of surgery, and before sleeping on the second and third nights after surgery. The Portable Sleep Monitor (PSM) was performed to determine the sleep quality of the two nights before the operation (Sleep preop 2 and Sleep preop 1) and the first and third night after surgery (Sleep POD 1 and Sleep POD 3). The visual analog scale (VAS) was performed to evaluate pain scores after surgery and the Athens Insomnia Scale (AIS) was used for evaluating subjective sleep quality.
Participants in the TEAS group had a lower AIS score and higher sleep efficiency at each time point except Sleep preop 2. Participants in the TEAS group showed significantly higher proportion of each sleep stage during Sleep-preop 1, Sleep POD 1, and Sleep POD 3. Patients in the TEAS group had significantly lower VAS scores at 2, 4, and 6 h during the first 24 h after surgery. The incidence of nausea and vomiting and dizziness in the control group was statistically higher than in the TEAS group.
Patients usually have sleep disturbances after video-assisted thoracoscopic surgery, such as decreased distribution of each sleep stage, lower sleep efficiency, and higher AIS score. Undergoing TEAS treatment perioperatively can improve sleep quality, and effectively promote the postoperative analgesic effect and alleviate postoperative complications.
术后睡眠障碍对术后结局有严重不良影响。本文旨在观察经皮穴位电刺激(TEAS)对接受选择性电视辅助胸腔镜手术患者术后睡眠质量和并发症的影响。
85例患者随机分为TEAS组和对照组。TEAS组在以下时间点进行30分钟的TEAS治疗:手术前第一晚、手术结束时、术后第二晚和第三晚睡觉前。采用便携式睡眠监测仪(PSM)测定术前两晚(术前睡眠2和术前睡眠1)以及术后第一晚和第三晚(术后第1天睡眠和术后第3天睡眠)的睡眠质量。采用视觉模拟量表(VAS)评估术后疼痛评分,采用雅典失眠量表(AIS)评估主观睡眠质量。
除术前睡眠2外,TEAS组在各时间点的AIS评分较低,睡眠效率较高。在术前睡眠1、术后第1天睡眠和术后第3天睡眠期间,TEAS组各睡眠阶段的比例显著更高。TEAS组患者术后24小时内2、4和6小时的VAS评分显著更低。对照组恶心呕吐和头晕的发生率在统计学上高于TEAS组。
电视辅助胸腔镜手术后患者通常存在睡眠障碍,如各睡眠阶段分布减少、睡眠效率降低和AIS评分升高。围手术期进行TEAS治疗可改善睡眠质量,有效促进术后镇痛效果并减轻术后并发症。