Effect Of Electro-acupuncture Acupoint Stimulation On Postoperative Neurocognitive Function And Pain In Patients With Gastrointestinal Surgery

Objective To observe the effect of electro-acupuncture at acupoints before operation on postoperative neurocognitive function and pain of patients undergoing open abdominal gastrointestinal tumor surgery.Methods 132 patients undergoing elective open surgery for gastrointestinal cancer under general anesthesia were divided into group A:Age≤59 years old,Group B:Age≥60 years old,66 cases in each group.Group A was randomly divided into groups A₁,A₂ and A₃,while group B was randomly divided into groups B₁,B₂ and B₃,with 22 cases in each group.Group A₁ and B₁ were not given electroacupuncture stimulation.Groups A₂ and B₂were given electroacupuncture stimulation one day before operation.Group A₃ and B₃ were stimulated one day before operation and 30 minutes before anesthesia induction.The acupoints are Baihui,Sishencong,Shenting and bilateral Neiguan.The parameters of electroacupuncture instrument were set as density wave,2/100Hz,2～3m A,and the acupuncture time was 30 minutes each time.The scores of mini-mental state examination（MMSE）,montreal cognitive assessment（MoCA）and the time of trail making test,（TMT）were recorded before opretion（T₀）,the first day（T₁）,the third day（T₂）and the seventh day（T₃）after operation.The scores of rest and dynamic visual analogue scale（VAS）were recorded at T₁,T₂ and T₃.Results一.Comparison of neurocognitive functions:1.Compared with groups A₁,A₂ and A₃,the MMSE score of groups B₁,B₂ and B₃ was lower and the TMT time was longer（P<0.05）.2.Comparison between groups in group A:There was no significant difference in MoCA score between A₂ group and A₁ group at T₁（P>0.05）,but the MoCA score in A₃ group was higher than that in A₁ and A₂ groups（P<0.05）.Intra group comparison in group A:Compared with T₀,the scores of MoCA in groups A₁ and A₂ decreased at T₁（P<0.05）,while those in group A₃ decreased,with no significant difference（P>0.05）.3.Comparison between groups in group B:There was no significant difference in MMSE,MoCA score and TMT time between group B₂and group B₁（P>0.05）,while the MoCA score in group B₃ was higher and TMT time was shorter than those in groups B₁ and B₂（P<0.05）.Intra group comparison in group B:Compared with T₀,MMSE and MoCA scores decreased and TMT time prolonged in all groups at T₁（P<0.05）.MoCA scores decreased and TMT time prolonged in B₁ and B₂ groups at T₂（P<0.05）,but there was no significant difference between MoCA scores and TMT time in B3 group（P>0.05）.二.The VAS score comparison:1.Comparison between B₁ and A₁:There was no significant difference in vasr and vasm scores of two groups at T₁ and T₂（P>0.05）,but the resting VAS score（vasr）of B₁ was higher than that of A₁ at T₃（P<0.05）.There was no significant difference in vasr and vasm scores between B₂ group and A₂ group,B₃ group and A₃ group at each time point（P>0.05）.2.Comparison between groups in group A:The vasr and vasm scores of A₂group and A₁group were not statistically significant（P>0.05）,while the vasr and vasm scores of A₃ group were lower than those of A₁ and A₂ group（P<0.05）at T₁.Intra group comparison in group A:Vasr and vasm were decreased at T₂ compared with T₁ and T₃ compared with T₂ in all groups（P<0.05）.3.Comparison between groups in Group B:There was no significant difference in vasr and vasm scores in B₂and B₁ groups at T₁ and T₂（P>0.05）,while group B₃ was lower than groups B₁ and B₂（P<0.05）.Intra group comparison in group A:Vasr and vasm were decreased at T₂ compared with T₁ and T₃ compared with T₂ in all groups（P<0.05）.Conclusion 1.Preoperative electroacupuncture at acupoints can improve postoperative neurocognitive impairment and postoperative pain of patients undergoing open abdominal gastrointestinal tumor surgery.2.The effect of improving postoperative neurocognitive impairment is more obvious in patients aged≤59 than in patients aged≥60,and the effect of relieving postoperative resting pain is more obvious in patients aged≥60 than in patients aged≤59.3.The effect of electroacupuncture at acupoints multiple times before operation on improving cognition and pain is more obvious than that without stimulation or single stimulation.