The effect of TEAS on the quality of early recovery in patients undergoing gynecological laparoscopic surgery: a prospective, randomized, placebo-controlled trial

Xiangdi Yu, Fangxiang Zhang, Bingning Chen, Xiangdi Yu, Fangxiang Zhang, Bingning Chen

Abstract

Introduction: In current study we assessed the effect of transcutaneous electrical acupoint stimulation (TEAS) on the quality of early recovery in patients undergoing gynecological laparoscopic surgery.

Methods: Sixty patients undergoing gynecological laparoscopic surgery were randomly assigned to TEAS (TEAS group) or control group (Con group). TEAS consisted of 30 min of stimulation (12-15 mA, 2/100 Hz) at the acupoints of Baihui (GV20), Yingtang (EX-HN-3), Zusanli (ST36) and Neiguan (PC6) before anesthesia. The patients in the Con group had the electrodes applied, but received no stimulation. Quality of recovery was assessed using a 40-item questionnaire as a measure of quality of recovery (QoR-40; maximum score 200) scoring system performed on preoperative day 1 (T0), postoperative day 1 (T1) and postoperative day 2 (T2); 100-mm visual analogue scale (VAS) scores at rest, mini-mental state examination (MMSE) scores, the incidence of nausea and vomiting, postoperative pain medications, and antiemetics were also recorded.

Results: QoR-40 and MMSE scores of T0 showed no difference between two groups (QoR-40: 197.50 ± 2.57 vs. 195.83 ± 5.17), (MMSE: 26.83 ± 2.74 vs. 27.53 ± 2.88). Compared with the Con group, QoR-40 and MMSE scores of T1 and T2 were higher in the TEAS group (P < 0.05) (QoR-40: T1, 166.07 ± 8.44 vs. 175.33 ± 9.66; T2, 187.73 ± 5.47 vs. 191.40 ± 5.74), (MMSE: T1, 24.60 ± 2.35 vs. 26.10 ± 2.78; T2, 26.53 ± 2.94 vs. 27.83 ± 2.73). VAS scores of T1 and T2 were lower (P < 0.05) in the TEAS group (T1, 4.73 ± 1.53 vs. 3.70 ± 1.41; T2, 2.30 ± 0.95 vs. 1.83 ± 0.88); the incidence of postoperative nausea and vomiting (PONV), remedial antiemetics and remedial analgesia was lower in the TEAS group (P < 0.05) (PONV: 56.7% vs. 23.3%; incidence of remedial antiemetics: 53.3% vs. 23.3%; incidence of remedial analgesia: 80% vs. 43.3%).

Conclusion: The use of TEAS significantly promoted the quality of early recovery, improved MMSE scores and reduced the incidence of pain, nausea and vomiting in patients undergoing gynecological laparoscopic surgery.

Trial registration: ClinicalTrials.gov, NCT02619578. Registered on 2 December 2015. Trial registry name: https://clinicaltrials.gov.

Keywords: Gynecological laparoscopic surgery; MMSE; QoR-40; Transcutaneous electric acupoint stimulation (TEAS); VAS.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Consolidated standards of reporting trials (Consort) flowchart. TEAS, Transcutaneous electrical acupoint stimulation
Fig. 2
Fig. 2
Location of acupoints. Baihui (GV20), located on the continuation of the line connecting the lowest and highest points of the ear, on the median line of the head, 7 cun above the posterior hairline, and 5 cun behind the anterior hairline; Yingtang (EX-HN-3), the middle point of the line between the brow bones; Zusanli (ST36), 3cun below Dubi (S35), one finger breadth from the anterior crest of the tibia; Neiguan (PC6), on the palmar side of the forearm and on the line connecting Quze (PC 3) and Daling (PC7), 2 cun above the crease of the wrist
Fig. 3
Fig. 3
Flow diagram showing the study procedures and number of patients. TEAS, transcutaneous electric acupoint stimulation; TCI, target controlled infusion; EA, electroacupuncture; Con, control; MMSE, Mini Mental State Examination; VAS, visual analogue scale
Fig. 4
Fig. 4
Scores on the global 40-item questionnaire as a measure of quality of recovery (QoR-40). When T0 was used as a covariate for a repeated measures model of T1 and T2, the significance of the interaction of group and time course was 0.003 and 0.036, respectively; *P = 0.040 control (Con) vs. electric acupoint stimulation (TEAS) at postoperative day 1 (T1); #P = 0.015 Con. vs. TEAS at postoperative day 2 (T2)
Fig. 5
Fig. 5
Scores on the Mini Mental State Examination (MMSE)

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