Objective

2

To observe the effect of perioperative transcutaneous electrical acupoint stimulation (TEAS) on postoperative fatigue syndrome (POFS) in elderly patients undergoing laparoscopic radical gastrectomy.

Methods

2

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.

Results

2

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 (

P

<

0.001); on 3 and 7 days after surgery

the POFS incidence rates were lower than those in the sham TEAS group (

P

<

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 (

P

<

0.05

P

<

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 (

P

<

0.001

P

<

0.01); on 1

3

7 days after surgery

the serum levels of TNF-α were lower than those in the sham TEAS group (

P

<

0.01

P

<

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 (

P

<

0.001

P

<

0.01

P

<

0.05); the intraoperative dosage of remifentanil was lower than that in the sham TEAS group (

P

<

0.001); the incidence rate of postoperative nausea and vomiting was lower than that in the sham TEAS group (

P

<

0.01).

Conclusion

2

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.