Xing Ruyi, Yang Yang, Zhang Min, Wang Hanyu, Tan Mengyuan, Gao Chen, Yang Chao, Zhai Mingyu, Xie Yanhu
Department of Anaesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
Pain Ther. 2022 Dec;11(4):1327-1339. doi: 10.1007/s40122-022-00429-2. Epub 2022 Sep 13.
This study assessed the influence of transcutaneous electrical acupoint stimulation (TEAS) combined with transversus abdominis plane block (TAPB) on the recovery of elderly patients undergoing laparoscopic gastric cancer surgery.
Ninety patients (age ≥ 60 years) undergoing laparoscopic gastric cancer surgery were randomly divided into general anesthesia group (group G), TAPB group (group NG), and TEAS combined with TAPB group (group NTG). Patients in the NTG group received TEAS at PC6, LI4, and ST36 acupoints and TAPB. Patients in the NG group received TAPB. The quality of recovery (QoR) was assessed using the QoR-15 questionnaire. The percentages of T lymphocyte subsets were determined. Consumption of anesthetics, extubation time, visual analog scale (VAS) scores, time of first postoperative ambulation and flatus, and postoperative adverse events were also recorded.
QoR-15 scores on postoperative day (POD) 3 and POD 7 were higher in the NTG group than in the G and NG groups (P < 0.05). On POD 1 and POD 3, the percentages of CD3 and CD4 T cells and the CD4/CD8 ratio were higher and the percentage of CD8 T cells was lower in the NTG group than in the G and NG groups (P < 0.05). Remifentanil consumption, and the incidence of postoperative nausea and vomiting (PONV) were lower and extubation time and time of first postoperative flatus were shorter in the NTG group than in the G and NG groups (P < 0.05). Compared with the G group, the VAS scores on POD 1 were lower in the NG group and those on POD 2 were lower in the NTG group (P < 0.05).
The combination of TEAS and TAPB ameliorated postoperative pain, improved immune and gastrointestinal function, reduced the incidence of PONV, and effectively promoted postoperative recovery in elderly patients undergoing laparoscopic gastric cancer surgery.
Chinese Clinical Trial Registry (ChiCTR2100042119).
本研究评估了经皮穴位电刺激（TEAS）联合腹横肌平面阻滞（TAPB）对老年腹腔镜胃癌手术患者恢复情况的影响。
90例年龄≥60岁的腹腔镜胃癌手术患者被随机分为全身麻醉组（G组）、TAPB组（NG组）和TEAS联合TAPB组（NTG组）。NTG组患者在双侧内关穴（PC6）、双侧合谷穴（LI4）和双侧足三里穴（ST36）接受经皮穴位电刺激并进行腹横肌平面阻滞。NG组患者接受腹横肌平面阻滞。采用QoR - 15问卷评估恢复质量。测定T淋巴细胞亚群百分比。记录麻醉药用量、拔管时间、视觉模拟评分（VAS）、术后首次下床活动和排气时间以及术后不良事件。
NTG组术后第3天（POD 3）和第7天（POD 7）的QoR - 15评分高于G组和NG组（P < 0.05）。在术后第1天（POD 1）和第3天（POD 3），NTG组CD3和CD4 T细胞百分比及CD4/CD8比值高于G组和NG组，而CD8 T细胞百分比低于G组和NG组（P < 0.05）。NTG组瑞芬太尼用量、术后恶心呕吐（PONV）发生率低于G组和NG组，拔管时间和术后首次排气时间短于G组和NG组（P < 0.05）。与G组相比，NG组术后第1天VAS评分较低，NTG组术后第2天VAS评分较低（P < 0.05）。
TEAS与TAPB联合应用可减轻老年腹腔镜胃癌手术患者术后疼痛，改善免疫和胃肠功能，降低PONV发生率，有效促进术后恢复。
中国临床试验注册中心（ChiCTR2100042119）
