Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang City, Hebei, People's Republic of China.
Department of Anesthesiology, Cangzhou Central Hospital, Cangzhou, Hebei, People's Republic of China.
Clin Interv Aging. 2021 May 3;16:757-765. doi: 10.2147/CIA.S309082. eCollection 2021.
Postoperative cognitive decline (POCD) in the old ages seriously delays the rapid recovery. Here, we aimed to investigate the effects of transcutaneous electrical acupoint stimulation (TEAS) against POCD in elderly patients undergoing laparoscopic radical colon cancer surgery, as well as the potential mechanism.
A prospective, single-center, parallel-group, randomized trial was designed. A total of 100 patients (age ≥65 years) undergoing laparoscopic radical resection of colon cancer were involved and randomly divided into TEAS (Group T) and control (Group C) groups. The patients in Group T were performed with percutaneous acupoint electrical stimulation in bilateral Hegu, Neiguan and Zusanli points from 30 minutes before anesthesia induction to the end of surgery. A Z-score based on Mini-Mental State Exam (MMSE) was used to assess the incidence of POCD. The levels of serum IL-6, hs-CRP, CGRP at 0 min before TEAS (T0), 1 h after beginning of surgery (T1) and the end of surgery (T2) were evaluated.
Our data showed that the cumulative duration of POCD on postoperative day 2 and 3 in Group T was significantly decreased compared to Group C ( < 0.05). Compared with T0, the levels of serum IL-6, hs-CRP, and CGRP in both Group T and C were statistically elevated at T1 and T2 ( < 0.05). Moreover, the levels of serum IL-6 and hs-CRP were decreased, but the level of CGRP was increased in Group T compared to Group C at T1 and T2 ( < 0.05).
TEAS is associated with a lower cumulative duration of POCD in elderly patients undergoing laparoscopic radical colon cancer surgery, which may be related to the regulation of inflammatory factors and neuropeptides interacted with gut-brain axis.
老年患者术后认知功能障碍(POCD)严重延缓了快速康复。在此,我们旨在研究经皮穴位电刺激(TEAS)对老年患者腹腔镜结肠癌根治术后 POCD 的影响及其潜在机制。
设计了一项前瞻性、单中心、平行组、随机试验。共纳入 100 例(年龄≥65 岁)接受腹腔镜结肠癌根治性切除术的患者,并随机分为 TEAS(T 组)和对照组(C 组)。T 组患者从麻醉诱导前 30 分钟至手术结束时行双侧合谷、内关和足三里穴位经皮穴位电刺激。采用基于简易精神状态检查(MMSE)的 Z 评分评估 POCD 的发生率。评估 TEAS 前 0 分钟(T0)、手术开始后 1 小时(T1)和手术结束时(T2)血清 IL-6、hs-CRP 和 CGRP 水平。
我们的数据显示,与 C 组相比,T 组术后第 2 天和第 3 天 POCD 的累积持续时间明显减少(<0.05)。与 T0 相比,T1 和 T2 时 T 组和 C 组血清 IL-6、hs-CRP 和 CGRP 水平均升高(<0.05)。此外,与 C 组相比,T1 和 T2 时 T 组血清 IL-6 和 hs-CRP 水平降低,CGRP 水平升高(<0.05)。
TEAS 与老年患者腹腔镜结肠癌根治术后 POCD 的累积持续时间较短有关,这可能与肠道-大脑轴相互作用的炎症因子和神经肽的调节有关。