Huang Hao-Xun, Wang Xing-He, Zhang Yan, Zhang Jin, Li Teng, Wang Zi-Heng, Zhu Yang-Zi, Wang Li-Wei
Xuzhou Central Hospital Postgraduate Training Base of Jinzhou Medical University, Xuzhou 221000, Jiangsu Province, China.
Anesthesiology Department, Xuzhou Central Hospital, Xuzhou 221000, Jiangsu Province.
Zhen Ci Yan Jiu. 2025 Feb 25;50(2):190-196. doi: 10.13702/j.1000-0607.20231101.
OBJECTIVES: To explore the effect of transcutaneous auricular vagus nerve stimulation (taVNS) combined with patient-controlled intravenous analgesia (PCIA) on postoperative pain in patients undergoing total knee arthroplasty (TKA). METHODS: A total of 140 patients with TKA were randomly divided into the taVNS group (=70, with 5 dropped-out) and the sham stimulation group (=70, with 6 dropped-out). The taVNS group received taVNS at the left ear conchae combined with PCIA treatment, while the sham stimulation group received sham taVNS at the left ear conchae combined with PCIA treatment. The time-weighted average (TWA) pain score, visual analogue scale (VAS) score of 1-7 days after surgery, the occurrence of adverse reactions such as nausea, vomiting, skin pruritus, drowsiness, respiratory depression, and the number of PCIA pump compressions within 48 hours after surgery were observed and compared between the 2 groups. The Beck Anxiety Inventory (BAI) scores, Bake Depression Inventory (BDI) scores, and Pittsburgh Sleep Quality Index (PSQI) scores were obtained on the day before surgery and 7 days after surgery. RESULTS: Compared with the sham stimulation group, the TWA pain score of the taVNS group was significantly decreased at the 7 day postoperatively (<0.01), and the VAS scores of the taVNS group were significantly lower than those of the sham stimulation group on postoperative days 3, 4, and 5 (<0.001, <0.01, <0.05), with no statistical significance in VAS scores on postoperative days 1, 2, 6, and 7. Compared with the sham stimulation group, the incidence of nausea and the number of PCIA pump compressions within 48 hours after surgery in the taVNS group was significantly decreased (<0.05). There was no statistical significance in the differences between the BDI, BAI, and PSQI scores before and after surgery in both groups. PSQI scores in the sham stimulation group and taVNS group were significantly lower than those in the same group 1 day before surgery (<0.01, <0.001). CONCLUSIONS: The taVNS combined with PCIA can reduce postoperative pain, the incidence of nausea, and the opioid dosage in TKA patients.
目的：探讨经皮耳迷走神经刺激（taVNS）联合患者自控静脉镇痛（PCIA）对全膝关节置换术（TKA）患者术后疼痛的影响。 方法：将140例TKA患者随机分为taVNS组（n = 70，失访5例）和假刺激组（n = 70，失访6例）。taVNS组在左耳甲结合PCIA治疗，假刺激组在左耳甲进行假taVNS结合PCIA治疗。观察并比较两组术后1 - 7天的时间加权平均（TWA）疼痛评分、视觉模拟量表（VAS）评分、恶心、呕吐、皮肤瘙痒、嗜睡、呼吸抑制等不良反应的发生情况以及术后48小时内PCIA泵按压次数。在术前1天和术后7天获取贝克焦虑量表（BAI）评分、贝克抑郁量表（BDI）评分和匹兹堡睡眠质量指数（PSQI）评分。 结果：与假刺激组相比，taVNS组术后7天的TWA疼痛评分显著降低（P < 0.01），且taVNS组术后第3、4、5天的VAS评分显著低于假刺激组（P < 0.001、P < 0.01、P < 0.05），术后第1、2、6、7天的VAS评分差异无统计学意义。与假刺激组相比，taVNS组术后恶心发生率及术后48小时内PCIA泵按压次数显著减少（P < 0.05）。两组术前、术后BDI、BAI和PSQI评分差异无统计学意义。假刺激组和taVNS组术后PSQI评分均显著低于术前1天同一组（P < 0.01、P < 0.001）。 结论：taVNS联合PCIA可减轻TKA患者术后疼痛、恶心发生率及阿片类药物用量。
Zotero 插件