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经皮耳迷走神经低强度刺激可减少腹腔镜结直肠癌根治术后肠麻痹:一项随机对照试验。

Low-intensity transcutaneous auricular vagus nerve stimulation reduces postoperative ileus after laparoscopic radical resection of colorectal cancer: a randomized controlled trial.

机构信息

Department of Anesthesiology, the First Affiliated Hospital of Nanchang University, Nanchang, China -

Department of Medicine, Graduate School, Nanchang University, Nanchang, China.

出版信息

Minerva Anestesiol. 2023 Mar;89(3):149-156. doi: 10.23736/S0375-9393.22.16735-0. Epub 2022 Nov 3.

Abstract

BACKGROUND

Postoperative ileus (POI) is thought to result from a disrupted sympathetic/parasympathetic balance caused by trauma or surgery. Transcutaneous auricular vagus nerve stimulation (tVNS) is a non-invasive technique involving stimulation of the vagal auricular branch, leading to autonomic regulation and reduced inflammation. Here, the effects of low-intensity transcutaneous auricular vagal stimulation on POI after laparoscopic radical resection of colorectal cancer were investigated.

METHODS

One hundred and thirty-four patients who received scheduled laparoscopic radical resection of colorectal cancer were randomly allocated to the A and B groups. The A group received low-intensity (25 Hz, 50 mA) transcutaneous electrical stimulation of the right auricular branch for 20 minutes prior to anesthesia while the B group did not. The primary outcome was the incidence of POI.

RESULTS

The incidence of POI in the A group was 6.25% and 20% in the B group (P=0.022). Patients in the A group showed more regular bowel sounds after 24, 36, and 48 h than those in the B group (P<0.001).

CONCLUSIONS

Low-intensity transcutaneous auricular vagal stimulation reduced POI after laparoscopic radical resection of colorectal cancer.

摘要

背景

术后肠麻痹(POI)被认为是由创伤或手术引起的交感/副交感神经平衡紊乱所致。经皮耳迷走神经刺激(tVNS)是一种非侵入性技术,涉及刺激迷走神经耳支,从而实现自主调节和减少炎症。本研究旨在探讨低强度经皮耳迷走神经刺激对腹腔镜结直肠癌根治术后 POI 的影响。

方法

将 134 例行择期腹腔镜结直肠癌根治术的患者随机分为 A 组和 B 组。A 组在麻醉前接受右侧耳甲支 25 Hz、50 mA 的低强度经皮电刺激 20 分钟,B 组不接受刺激。主要结局是 POI 的发生率。

结果

A 组 POI 的发生率为 6.25%,B 组为 20%(P=0.022)。与 B 组相比,A 组患者在 24、36 和 48 小时后肠鸣音更规律(P<0.001)。

结论

低强度经皮耳迷走神经刺激可减少腹腔镜结直肠癌根治术后 POI 的发生。

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