Department of General Surgery, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000, Kuala Lumpur, Malaysia.
Department of General Surgery, Hospital Sultanah Aminah Johor Bahru, Ministry of Health Malaysia, Jalan Persiaran Abu Bakar Sultan, 80100, Johor Bahru, Johor, Malaysia.
Surg Endosc. 2024 Jun;38(6):3279-3287. doi: 10.1007/s00464-024-10841-8. Epub 2024 Apr 24.
Oesophagogastroduodenoscopy (OGDS) is the most common diagnostic procedure for upper gastrointestinal diseases. It often causes discomfort and anxiety, which are only mitigated by systemic sedation. However, sedation poses additional risks of adverse cardiopulmonary events, increased medical costs, and prolonged recovery. Transcutaneous electrical nerve stimulation of acupuncture points (Acu-TENS) is a non-invasive and innovative approach that induces analgesic effect during endoscopy. This trial is the first to be reported in English that explores the potential of Acu-TENS to increase patient tolerance during non-sedated elective diagnostic OGDS.
A double-blinded randomized controlled trial involving 348 subjects was conducted at a tertiary hospital to evaluate the success rate of OGDS with Acu-TENS. Subjects aged 18-75 years scheduled for their first elective diagnostic OGDS were randomized into the intervention (Acu-TENS) and placebo arms. OGDS success was assessed based on subjects' satisfaction ratings on a Likert scale and procedure's technical adequacy. Secondary measures included subjects' willingness to undergo future OGDS under similar conditions, procedure duration, and the endoscopist's perceived ease of the procedure.
OGDS success rates were significantly higher with Acu-TENS (77.8%) than with the placebo (68.0%; odds ratio [OR] 1.64, 95% confidence interval [CI] 1.01-2.66, p = 0.043). Subjects who received Acu-TENS expressed higher willingness for future OGDS (78.9%) than those who received the placebo (68.6%; OR 1.71, 95% CI 1.04-2.79, p = 0.031). Procedure duration were significantly shorter in the intervention arm (6.0 min) than in the placebo arm (10.0 min; p = 0.002). No adverse effects were reported, and endoscopists perceived similar procedure ease in both arms.
Acu-TENS improved OGDS success and enhanced patients' experiences during non-sedated OGDS. It demonstrated safety with no side effects and reduced the procedure completion time. It could be used as an adjunct in non-sedated diagnostic OGDS.
上消化道疾病最常见的诊断方法是食管胃十二指肠镜检查（OGDS）。它通常会引起不适和焦虑，只能通过全身镇静来缓解。然而，镇静会增加心肺不良事件、医疗费用增加和恢复时间延长的风险。经皮穴位电刺激（Acu-TENS）是一种非侵入性和创新性的方法，可在内镜检查时诱导镇痛效果。这是首次用英语报告的试验，旨在探讨 Acu-TENS 提高非镇静选择性诊断性 OGDS 中患者耐受性的潜力。
在一家三级医院进行了一项涉及 348 名受试者的双盲随机对照试验，以评估 Acu-TENS 在 OGDS 中的成功率。年龄在 18-75 岁之间，计划进行首次选择性诊断性 OGDS 的受试者被随机分为干预（Acu-TENS）和安慰剂组。OGDS 成功率根据受试者对李克特量表的满意度评分和程序的技术充分性进行评估。次要措施包括受试者在类似条件下接受未来 OGDS 的意愿、程序持续时间和内镜医生对程序的感知难易程度。
Acu-TENS 组的 OGDS 成功率（77.8%）明显高于安慰剂组（68.0%；比值比[OR]1.64，95%置信区间[CI]1.01-2.66，p=0.043）。接受 Acu-TENS 的受试者表示愿意接受未来的 OGDS（78.9%）的比例明显高于接受安慰剂的受试者（68.6%；OR 1.71，95%CI 1.04-2.79，p=0.031）。干预组的程序持续时间明显短于安慰剂组（6.0 分钟）（10.0 分钟；p=0.002）。没有报告不良反应，内镜医生认为两个手臂的程序难度相似。
Acu-TENS 提高了非镇静性 OGDS 的成功率，并增强了患者在非镇静性 OGDS 期间的体验。它具有安全性，没有副作用，并且缩短了程序完成时间。它可以作为非镇静诊断性 OGDS 的辅助手段。
