Yin Xuefeng, Qiao Shuang, Zhang Ling, Li Zhonghua, Zhang Qin, Shen Yu, Fan Keyu, Liu Mingxia, Wang Dongxu, Cao Ya, Zhang Yuxuan, Qian Lu, Wu Danru, Wei Jingqiu, Yang Ying, Liu He
Department of Anesthesiology and Clinical Research Center for Anesthesia and Perioperative Medicine and Key Laboratory of Anesthesia and Analgesia Application Technology, Huzhou Central Hospital, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, Zhejiang, China.
Huzhou Central Hospital, The Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China.
Front Med (Lausanne). 2025 Jun 2;12:1588850. doi: 10.3389/fmed.2025.1588850. eCollection 2025.
Postoperative fatigue syndrome (POFS) comprises symptoms including fatigue, insomnia, inattention, depression, tension, and anxiety following surgery. These manifestations encompass exhaustion, weakness, malaise, and emotional disturbances, impacting hospital stay duration, quality of life, rehabilitation progress, and work performance. While the etiology of POFS remains complex, recent evidence suggests that external stimuli may induce pro-inflammatory cytokine release, leading to fatigue. Surgical procedures trigger an inflammatory reaction that stimulates the nervous system, generating fatigue symptoms. Both animal and human studies demonstrate that vagus nerve stimulation (VNS) can reduce pro-inflammatory cytokine production by activating the cholinergic anti-inflammatory pathway (CAP). Considering the pivotal role of inflammation in the development of POFS and the vagus nerve's capacity to modulate inflammatory responses, we hypothesize that transcutaneous auricular vagus nerve stimulation (taVNS) holds significant potential for alleviating POFS in elderly patients undergoing colorectal cancer surgery. In this paper, we propose a hypothetical scheme to validate this hypothesis through the application of taVNS in future clinical studies.
术后疲劳综合征(POFS)包括术后出现的疲劳、失眠、注意力不集中、抑郁、紧张和焦虑等症状。这些表现包括疲惫、虚弱、不适和情绪障碍,影响住院时间、生活质量、康复进程和工作表现。虽然POFS的病因仍然复杂,但最近的证据表明,外部刺激可能会诱导促炎细胞因子释放,从而导致疲劳。手术操作会引发炎症反应,刺激神经系统,产生疲劳症状。动物和人体研究均表明,迷走神经刺激(VNS)可通过激活胆碱能抗炎通路(CAP)来减少促炎细胞因子的产生。鉴于炎症在POFS发生发展中的关键作用以及迷走神经调节炎症反应的能力,我们推测经皮耳迷走神经刺激(taVNS)在减轻接受结直肠癌手术的老年患者的POFS方面具有巨大潜力。在本文中,我们提出了一个假设方案,以便通过在未来的临床研究中应用taVNS来验证这一假设。
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