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经皮穴位电刺激对电视辅助胸腔镜肺叶切除术后慢性疼痛的疗效:一项前瞻性随机对照试验的研究方案

Efficacy of Transcutaneous Electrical Acupoint Stimulation on Chronic Postsurgical Pain After Video-Assisted Thoracoscopic Lobectomy: Study Protocol for a Prospective Randomized Controlled Trial.

作者信息

Chen Shuang, Ding Ying, Zhang Xiaoming, Zhang Xue, Xiang Jiajia, Deng Yiling, Tao Xingran, Cai Wenke, Li Zhigui, Chen Jiayu, Kong Fanyi, Li Na

机构信息

Department of Anesthesiology, 920th Hospital of Joint Logistics Support Force, 212 Daguan Road, Xishan District, Kunming, Yunnan, China.

Kunming Medical University, Kunming, Yunnan, China.

出版信息

Pain Ther. 2024 Apr;13(2):269-280. doi: 10.1007/s40122-024-00580-y. Epub 2024 Feb 17.

Abstract

INTRODUCTION

Patients undergoing video-assisted thoracoscopic lobectomy (VATL) often experience chronic postsurgical pain (CPSP). Postoperative pain can affect the recovery of postoperative lung function, prolong postoperative recovery time, and increase patient hospitalization expenses. Transcutaneous electrical acupoint stimulation (TEAS) is an alternative therapy based on acupuncture that has shown promise in postoperative recovery and pain management across various medical fields. However, research specifically focused on the improvement of CPSP after VATL is currently lacking. The purpose of this study is to evaluate whether TEAS can effectively reduce the severity and occurrence of chronic postsurgical pain in patients undergoing VATL. By investigating the potential benefits of TEAS in mitigating CPSP after VATL, this study aims to provide valuable clinical evidence to support the integration of TEAS into postoperative care protocols for patients undergoing VATL.

METHODS

This study is a prospective, single-center, double-blinded, randomized controlled trial to be conducted at the 920th Hospital of Joint Logistics Support Force. Eighty patients undergoing VATL will be randomly divided into an experimental group (TEAS group) and a control group (sham group). The experimental group will receive TEAS at bilateral PC6, LI4, LR3, LU5, TE5, and LI11. The control group will not receive TEAS at the same acupoints. Both groups will receive TEAS or no TEAS before anesthesia induction and 1-7 days after surgery, with each session lasting 30 min.

PLANNED OUTCOMES

The primary outcome will be the incidence of CPSP at 3 months after surgery. Secondary outcomes will include the incidence of CPSP at 6 months after surgery, the numerical rating scale (NRS) scores at 3 and 6 months after surgery, as well as the NRS scores at 24, 48, and 72 h after surgery, remifentanil consumption during general anesthesia, demand for rescue analgesics, number and duration of indwelling chest tubes, incidence of postoperative nausea and vomiting, and changes of norepinephrine (NE), cortisol (Cor), tumor necrosis factor (TNF- α), and interleukin 6 (IL-6) in serum.

TRIAL REGISTRATION

ChiCTR2300069458. Registered on March 16, 2023.

摘要

引言

接受电视辅助胸腔镜肺叶切除术(VATL)的患者常经历慢性术后疼痛(CPSP)。术后疼痛会影响术后肺功能的恢复,延长术后恢复时间,并增加患者住院费用。经皮穴位电刺激(TEAS)是一种基于针灸的替代疗法,在各个医学领域的术后恢复和疼痛管理方面已显示出前景。然而,目前缺乏专门针对VATL后CPSP改善情况的研究。本研究的目的是评估TEAS是否能有效降低接受VATL患者慢性术后疼痛的严重程度和发生率。通过研究TEAS在减轻VATL后CPSP方面的潜在益处,本研究旨在提供有价值的临床证据,以支持将TEAS纳入接受VATL患者的术后护理方案。

方法

本研究是一项前瞻性、单中心、双盲、随机对照试验,将在联勤保障部队第920医院进行。80例接受VATL的患者将被随机分为实验组(TEAS组)和对照组(假手术组)。实验组将在双侧内关穴(PC6)、合谷穴(LI4)、太冲穴(LR3)、尺泽穴(LU5)、外关穴(TE5)和曲池穴(LI11)接受TEAS治疗。对照组将不在相同穴位接受TEAS治疗。两组将在麻醉诱导前和术后1 - 7天接受TEAS或不接受TEAS治疗,每次治疗持续30分钟。

预期结果

主要结果将是术后3个月时CPSP的发生率。次要结果将包括术后6个月时CPSP的发生率、术后3个月和6个月时的数字评分量表(NRS)评分,以及术后24、48和72小时的NRS评分、全身麻醉期间瑞芬太尼的消耗量、急救镇痛药的需求量、留置胸管的数量和持续时间、术后恶心呕吐的发生率,以及血清中去甲肾上腺素(NE)、皮质醇(Cor)、肿瘤坏死因子(TNF-α)和白细胞介素6(IL-6)的变化。

试验注册

ChiCTR2300069458。于2023年3月16日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6ce/10928028/ff8f7f425be7/40122_2024_580_Fig1_HTML.jpg

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