Cheng Jing, Hu Shiyi, Fang Yuru, Cao Guixia, Jiang Tao, Wang Yiqiao
Graduate School, Bengbu Medical University, Bengbu 233030, Anhui Province, China.
Department of Anesthesiology, Anhui No.2 Provincial People's Hospital, Hefei 230041.
Zhongguo Zhen Jiu. 2025 Aug 12;45(8):1071-1077. doi: 10.13703/j.0255-2930.20240814-k0004. Epub 2025 Feb 28.
To observe the effect of perioperative transcutaneous electrical acupoint stimulation (TEAS) on postoperative fatigue syndrome (POFS) in elderly patients undergoing laparoscopic radical gastrectomy.
A total of 80 elderly patients scheduled for laparoscopic radical gastrectomy were randomized into a TEAS group and a sham TEAS group, 40 cases in each one. In the TEAS group, TEAS intervention was applied at bilateral Hegu (LI4), Neiguan (PC6), Zusanli (ST36) and Sanyinjiao (SP6) from 30 min before anesthesia induction until surgery completion, and at 18:00 on 1st, 2nd and 3rd days after surgery, once a day, 30 min a time. In the sham TEAS group, the same acupoints were selected and connected to the electroacupuncture device at the same time, without electrical stimulation. One day before surgery and 1, 3, 7 days after surgery, the 10-item short form of identity consequence fatigue scale (ICFS-10) score was observed, and the POFS incidence rate of 1, 3, 7 days after surgery was assessed in the two groups. One day before surgery, surgery completion, and 1, 3 days after surgery, the serum levels of superoxide dismutase (SOD), β-endorphin (β-EP) were detected; 1 day before surgery and 1, 3, 7 days after surgery, the serum level of tumor necrosis factor-α (TNF-α) was detected in the two groups. The pain visual analog scale (VAS) score was observed at 24, 48 and 72 h after surgery; the intraoperative dosage of propofol and remifentanil, and the incidence rate of postoperative nausea and vomiting, itching, respiratory depression were recorded in the two groups.
In the TEAS group, on 1, 3, 7 days after surgery, except for the scores of item 8-10, the item scores and the total scores of ICFS-10 were lower than those in the sham TEAS group (<0.001); on 3 and 7 days after surgery, the POFS incidence rates were lower than those in the sham TEAS group (<0.05). In the TEAS group, on 1 and 3 days after surgery, the serum levels of SOD were higher than those in the sham TEAS group (<0.05, <0.01); at surgery completion, and on 1, 3 days after surgery, the serum levels of β-EP were higher than those in the sham TEAS group (<0.001, <0.01); on 1, 3, 7 days after surgery, the serum levels of TNF-α were lower than those in the sham TEAS group (<0.01, <0.001). In the TEAS group, at 24, 48 and 72 h after surgery, the pain VAS scores were lower than those in the sham TEAS group (<0.001, <0.01, <0.05); the intraoperative dosage of remifentanil was lower than that in the sham TEAS group (<0.001); the incidence rate of postoperative nausea and vomiting was lower than that in the sham TEAS group (<0.01).
Perioperative TEAS intervention can effectively reduce the incidence rate of POFS, improve fatigue symptom and mental state in elderly patients undergoing laparoscopic radical gastrectomy, its mechanism may related to enhancing endogenous β-EP release, inhibiting inflammatory response, and reducing central oxidative stress, thereby promoting postoperative recovery.
观察围手术期经皮穴位电刺激（TEAS）对老年腹腔镜根治性胃切除术患者术后疲劳综合征（POFS）的影响。
将80例拟行腹腔镜根治性胃切除术的老年患者随机分为TEAS组和假TEAS组，每组40例。TEAS组于麻醉诱导前30分钟至手术结束，以及术后第1、2、3天18:00，在双侧合谷（LI4）、内关（PC6）、足三里（ST36）和三阴交（SP6）进行TEAS干预，每天1次，每次30分钟。假TEAS组选取相同穴位，同时连接电针仪，但不给予电刺激。于术前1天及术后1、3、7天观察10项简易身份后果疲劳量表（ICFS-10）评分，并评估两组术后1、3、7天的POFS发生率。于术前1天、手术结束时及术后1、3天检测血清超氧化物歧化酶（SOD）、β-内啡肽（β-EP）水平；于术前1天及术后1、3、7天检测两组血清肿瘤坏死因子-α（TNF-α）水平。于术后24、48、72小时观察疼痛视觉模拟量表（VAS）评分；记录两组术中丙泊酚和瑞芬太尼用量及术后恶心呕吐、瘙痒、呼吸抑制发生率。
TEAS组术后1、3、7天，除第8-10项评分外，ICFS-10各条目评分及总分均低于假TEAS组（<0.001）；术后3、7天，POFS发生率低于假TEAS组（<0.05）。TEAS组术后1、3天血清SOD水平高于假TEAS组（<0.05，<0.01）；手术结束时及术后1、3天血清β-EP水平高于假TEAS组（<0.001，<0.01）；术后1、3、
