Abstract
PURPOSE: To investigate the effect of perioperative continuous TEAS on the incidence of POD in elderly patients undergoing laparoscopic gastrointestinal surgery. PATIENTS AND METHODS: In this prospective, double-blind, randomized controlled trial, 180 elderly patients (age ≥65 years, ASA I-III) scheduled for laparoscopic gastrointestinal surgery were randomized into three groups: Group A received continuous TEAS (n=60), Group B received twice TEAS (n=60), and Group C received sham TEAS (n=60). Groups A and B received TEAS at Yintang (EX-HN 3), bilateral Shenmen (HT 7), Neiguan (PC 6), and Zusanli (ST 36) 30 min before anesthesia induction and 30 min before the end of surgery. After the operation, Group A received electrical stimulation every 8 hours for 72 hours, Group B received no electrical stimulation after the operation, and Group C received only electrodes without current output. The primary outcome was the incidence of POD within 72 hours after surgery. RESULTS: Group A had a significantly lower POD incidence (11.9%) than Group B (31.0%, P'<0.017) and Group C (53.6%, P'<0.017), with Group B also lower than Group C (P'<0.017); Groups A (15.3%) and B (25.9%) had a lower postoperative nausea and vomiting (PONV) incidence than Group C (51.8%) (P'<0.017), as well as lower dizziness incidence (A: 6.8%, B: 12.1% vs C: 32.1%, A vs C: P'<0.017; B vs C: P'<0.017). Compared with Group C (first flatus: 71.91±10.59h; first defecation: 97.80±10.26h), Groups A and B had earlier first flatus (61.22±11.09h, 65.53±11.73h) and defecation (86.47±11.07h, 90.79±11.85h) (P'<0.017), and Group A had lower Pittsburgh Sleep Quality Index (PSQI) scores at 2 weeks and 1 month postoperatively than Group B (P'<0.017). No significant difference in skin injury incidence was observed among the three groups (P>0.05). CONCLUSION: Perioperative continuous TEAS significantly reduces the incidences of POD, PONV, and postoperative dizziness, effectively improves postoperative sleep quality, and accelerates the recovery of gastrointestinal function in elderly patients undergoing laparoscopic gastrointestinal surgery. Patients receiving TEAS did not experience an increased incidence of adverse events such as skin injury.