Hou Yu, Kang Fang, Liu Hongtao, Yang Chengwei, Han Mingming, Huang Xiang, Guan Xiaohong, Wang Shu-Ming, Li Juan
Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, China.
Department of Kidney Transplantation, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, China.
Heliyon. 2023 Mar 9;9(3):e14423. doi: 10.1016/j.heliyon.2023.e14423. eCollection 2023 Mar.
Living kidney donors (LKDs) experience perioperative anxiety. We designed the following study to evaluate the anxiolytic effect of transcutaneous electrical acupoint stimulation (TEAS) during the perioperative period in a group of LKDs undergoing laparotomy nephrectomy.
LKDs were randomly assigned to either the TEAS or control group. Participants in the TEAS group received 30min of intervention (6-15 mA, 2-100 Hz), at Yintang (EX-HN-3), bilateral Taichong (LR3) and Neiguan (PC6) one day before surgery (D), before induction of anesthesia (D) and one day after surgery (D). The participants in the control group received the same placement of electrodes but without electrical stimulation. Venous blood was collected before each intervention. Anxiety levels and recovery profiles were recorded.
LKDs in the TEAS group had lower anxiety level than those in the control group at D, D and three days after surgery (D). The percentage differences were: 33.3%, 25.0%, and 22.2%; [95% confidence interval (CI), (-55.1%, -11.6%), (-47.4%, -2.6%), and (-42.3%, -2.2%); = 0.005, = 0.034, and = 0.035; respectively]. LKDs who received TEAS had better sleep quality and short-term recovery profiles than those in the control group. The plasma levels of 5-hydroxytryptamine (5-HT) and melatonin (MT) in the TEAS group were significantly higher than those in the control group at D and D (5-HT: = 0.001, and < 0.001; MT: = 0.006, and = 0.001). At the 3-month follow up, fewer LKDs in the TEAS group had incisional pain when compared to the control group ( = 0.032).
Perioperative TEAS decreased perioperative anxiety and facilitated postoperative recovery in the LKDs, and potential decreased the development of chronic pain. Trial Registration: Registered at ChiCTR2000029891, http://www.chictr.org.cn/listbycreater.aspx.
活体肾供体（LKDs）在围手术期会经历焦虑情绪。我们设计了以下研究，以评估经皮穴位电刺激（TEAS）对一组接受剖腹肾切除术的LKDs围手术期焦虑的缓解作用。
将LKDs随机分为TEAS组或对照组。TEAS组的参与者在手术前一天（D0）、麻醉诱导前（D1）和手术后一天（D2），在印堂（EX-HN-3）、双侧太冲（LR3）和内关（PC6）接受30分钟的干预（6 - 15毫安，2 - 100赫兹）。对照组的参与者接受相同的电极放置，但不进行电刺激。在每次干预前采集静脉血。记录焦虑水平和恢复情况。
TEAS组的LKDs在D0、D1和术后三天（D3）的焦虑水平低于对照组。百分比差异分别为：33.3%、25.0%和22.2%；[95%置信区间（CI），（-55.1%，-11.6%）、（-47.4%，-2.6%）和（-42.3%，-2.2%）；P = 0.005、P = 0.034和P = 0.035；分别]。接受TEAS的LKDs比对照组具有更好的睡眠质量和短期恢复情况。TEAS组在D0和D1时血浆5-羟色胺（5-HT）和褪黑素（MT）水平显著高于对照组（5-HT：P = 0.001，P < 0.001；MT：P = 0.006，P = 0.001）。在3个月的随访中，与对照组相比，TEAS组切口疼痛的LKDs更少（P = 0.032）。
围手术期TEAS可降低LKDs的围手术期焦虑并促进术后恢复，还可能减少慢性疼痛的发生。试验注册：在ChiCTR2000029891注册，http://www.chictr.org.cn/listbycreater.aspx。
