Abstract
BACKGROUND: Patients undergoing high-risk surgical procedures frequently experience postoperative pulmonary complications (PPCs) that impact outcomes. Acupuncture has demonstrated potential benefits during surgery. Press needle stimulation is increasingly recognized as an alternative to conventional techniques. We aimed to evaluate the effect of press needle stimulation on PPCs in patients with lung cancer undergoing video-assisted thoracoscopic surgery. METHODS: Eighty-seven patients undergoing video-assisted thoracoscopic surgery were randomized into press needle (n = 48) or sham needle (n = 39) groups. The press needle group underwent bilateral stimulation of acupoints LU9 (Taiyuan), RN17 (Danzhong), LU6 (Kongzui), and BL13 (Feishu) before anesthesia and during surgery. The sham group received a placebo stimulation. The primary endpoint was the incidence of PPCs within seven days post-surgery. The secondary endpoints included cytokine levels, intraoperative respiratory mechanics, postoperative pain score, analgesic consumption, and related complications. RESULTS: Press needle acupoint stimulation was associated with a significantly lower incidence of PPCs than the sham needle group. Perioperative data, tachycardia, cough, postoperative nausea, vomiting, and most inflammatory markers exhibited no significant differences, except for lower hypoxia-inducible factor-1α levels in the press needle group. Hemodynamic and blood gas analyses indicated no significant cardiovascular or respiratory differences between groups. The press needle group exhibited reduced patient-controlled analgesia (PCA) pump utilization and lower total PCA usage, indicating improved pain management. CONCLUSION: This study indicates that press needle stimulation lowers PPC incidence and improves postoperative analgesia in patients with lung cancer undergoing video-assisted thoracoscopic lobectomy.