The Effects Of Transcutaneous Electrical Acupoint Stimulation On Postoperative Inflammatory Response Of Non-small-cell Lung Cancer Patients

Objective The purpose of this article is to find the effects of transcutaneous electrical acupoint stimulation on postoperative inflammatory response on non-small-cell lung cancer(NSCLC)patients.Method We selected the 30 patients who would receive video-assisted thoracoscopic lobectomy surgery due to NSCLE.The patients were randomized into two groups: Transcutaneous Electrical Acupoint Stimulation(Group A,n=15)and Transcutaneous Sham Electrical Acupoint Stimulation(Group B,n=15).Both groups were received total intravenous anesthesia.The anesthesia was both induced with midazolam,sufentanil,rocuronium and propofol TCI and was maintained with propofol TCI,remifentanil continuous infusion and cis-atracurium if needed.The Bis was maintained at 40 to 60.Patients in group A were stimulated on SI3,SJ6,PC6,and LI4 on both side by Han’s Acupoint Nerve Stimulator from 30 minutes before introduction to the end of surgery.The stimulate frequency was 2/100 Hz and the stimulate intensity was the maximum current that could be tolerated when the patient was awake.The control group received only TIVA general anesthesia and sham electrical stimulation.Group A also received stimulation at 6 hours and 24 hours after surgery.Serum from patients of both groups will be collected at before surgery(T0),1h(T1)and 25h(T2)after surgery,respectively and serum levels of TNF-α,IL-1β,CXCL-8 and IFN-γ at different time points will be measured.The primary outcome measures are serum TNF-α,IL-1β,CXCL-8 and IFN-γ levels at 1h after surgery.The secondary outcome measures include VAS score,the dose of analgesics during operation and the serum levels of TNF-α,IL-1β,CXCL8 and IFN-γ at 25 h post-surgery.Result 1 patient from Group A and 2 patients from Group B were excluded because of benign lesions or not NSCLC according to postoperative pathology.There are no statistical differences of the serum level of TNF-α,IL-1β and IFN-γ between Group A and Group B at all three time points.In Group B,the serum level of CXCL-8 at T1 is statistically higher than that at T0(P=0.001).The serum level of CXCL-8 of Group A is significantly lower than that of Group B at T1(73.39±12.72p/ml vs 91.13±12.63pg/ml,P=0.004).The dose of remifentanil in Group A is significantly lower than that in Group B(0.0996±0.0344ug/kg/min vs 0.1436±0.0485ug/kg/min,P=0.011).Conclusion TEAS can decrease the serum level of CXCL-8 and suppress the inflammatory response.It also has an analgesic effect and can reduce the use of analgesics.