| Background and Purpose: With the advancement of science and technology,methods of pain management and enhance the recovery of gastrointestinal function have gradually been diversified.Among them,transcutaneous electrical acupoint stimulation(TEAS)can be used as an innovative choice,but the effectiveness and safety of this traditional Chinese medicine(TCM)-derived technology for patients who underwent gastrectomy still needs more high-level evidence to support,including the reliability of acupoints selection,the rationality of clinical operation,and the cooperation of doctor-patient.So,the purpose of this study is to evaluate the effects of TEAS on pain relief and postoperative rehabilitation for patients who underwent laparoscopic radical gastrectomy.Patients and methods: From May 2019 to November 2019,a total of 96 gastric cancer patients were recruited from the Department of Gastrointestinal Surgery,Affiliated Hospital of Qingdao University.The enrolled patients were randomly divided into TEAS group(TG)and control group(CG)at a ratio of 1:1.Patients in the TEAS group received TEAS treatment on postoperative day(POD)1-3,2 times a day,30 minutes each time.The control group was given routine care only.The selected acupoints are bilateral Hegu(LI4),Neiguan(PC6),Weishu(BL21),Xiaochangshu(BL27),Zusanli(ST36)and Shangjuxu(ST37).The primary outcomes were pain score for 5 consecutive days after the operation and the consumption of analgesics during hospitalization.The secondary outcomes are the time of first postoperative flatus(h)and defecation(h),frequency of postoperative nausea,vomiting,distension,diarrhea,comfort of semi-liquid diet,Clavien-Dindo complication classification(C-D classification)and length of postoperativeday(d).We collected patients’ blood on POD 1,3,5 for analysis of white blood cell count(WBC),NEC%,C-reactive protein(CRP),procalcitonin(PCT),β-endorphin(β-End),and serotonin(5-HT),interleukin-2(IL-2),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and motilin(MTL)concentration to explore the possible mechanisms.Results: After screening,a total of 82 patients were enrolled in this trial;81 patients completed the trial and were included in the overall analysis.We observed that patients in the TEAS group had lower pain scores on POD 1-5 compared with the control group [POD 1: 3.00(0.42)vs 3.33(0.67);POD 2: 2.58(0.29)vs 3.17(0.58);POD 3: 2.25(0.33)vs 3.08(0.75);POD 4: 2.00(0.17)vs 2.83(0.58);POD 5: 1.75(0.21)vs 2.29(0.73);average: 2.55±0.21 vs 3.10±0.42,P<0.001)].In terms of the consumption of analgesics,the use rate of opioids in the TEAS group was also lower(43.9 vs 75.0,P=0.004).Additionally,in TEAS group the time of first postoperative flatus(55.63±16.74 vs 72.60±20.92,P<0.001)and defecation(72.20±16.24 vs 95.78±17.75,P<0.001)were shorter;the frequency of nausea were fewer(1.88±1.09 vs 2.58±0.77,P=0.029),and patients were more comfortable with semi-fluid diet(7.63±0.63 vs 6.93±0.69,P<0.001).Among the hematology results,in the TEAS group,the concentrations of β-End,IL-2,and MTL were lower on POD 3,POD 5;5-HT,IL-6,and TNF-α were higher.The above results are statistically significant.Conclusion: According to our trial results,it is confirmed that TEAS has a clear role in relieving postoperative pain and promoting the recovery of gastrointestinal function.In addition,patients had high compliance and no adverse reactions were reported during the entire trial.Consequently,it can be an adjunctive therapy to enhance postoperative recovery for patients after gastrectomy. |
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