| Objective By observing the effects of transcutaneous acupoint electrical stimulation on inflammatory response,postoperative recovery quality,knee joint function,pain and postoperative adverse reactions of patients after total knee replacement,and the differences of therapeutic effects of three different treatment frequencies(2Hz,100 Hz and 2/10Hz),the effects of transcutaneous acupoint electrical stimulation on inflammatory response and rapid rehabilitation after TKA were evaluated,which could guide the better treatment frequency of TEAS and provide reference for clinical decision-making.Methods 124 patients,aged 60～85 years,with ASA Ⅰ～Ⅱ,were scheduled to undergo unilateral TKA under subarachnoid block anesthesia.They were randomly divided into three groups: sham TEAS group(group A),2Hz TEAS group(group B),100 Hz TEAS group(group C)and 2/100 Hz TEAS group(group D).Before anesthesia induction,30 cases in each group,group A: no TEAS treatment;Group B: treated with TEAS and stimulated with continuous wave with frequency of 2Hz;Group C: treated with TEAS,and stimulated with continuous wave with frequency of 100 Hz;Group D:TEAS was given,and the frequency of stimulation was 2/100 Hz.The intensity of stimulation received by groups B,C and D is the maximum intensity that patients can tolerate or the muscle rhythmic tremor.The duration of stimulation was 60 min.All the subjects in the three groups were given intraspinal anesthesia and PCIA after operation.The levels of postoperative inflammatory factors in the four groups were recorded and compared.Acute c-reactive protein level;VAS scores at 6h,12 h,24h and 48 h after operation;QoR-40 recovery scale scores at 1 day and 7 days after operation;ROM;before operation and 7 days after operation;HSS score before operation and 7 days after operation;Incidence of postoperative anesthesia-related adverse reactions.Results(1)There is no difference between the four groups in gender,age,BMI,ASA classification and operation time(P > 0.05),which is comparable.(2)Levels of inflammatory factors: One day after operation,the serum levels of IL-1β,IL-6 and TNF-α in the four groups were higher than those before operation(P <0.05);Compared between groups,the serum levels of IL-1β,IL-6 and TNF-α in group B,C and D were lower than those in group A(P < 0.05),while those in group D were lower than those in group B and C(P < 0.05).There was no statistical difference between the two groups.(3)Comparison of CRP levels: On the 1st day after operation,the serum CRP levels of patients in group A,B,C and D were all higher than those before operation(P< 0.05);The comparison between groups showed that the serum CRP levels in group B,C and D were all lower than those in group A(P < 0.05),and the serum CRP levels in group D were lower than those in groups B and C(P < 0.05),and there was no statistical difference between groups B and C(P > 0.05).(4)QoR-40 score comparison: On the 1st day after operation,the QoR-40 scores of the three groups B,C and D were higher than those of the group A(P < 0.05),and there was no statistical difference among the three groups B,C and D(P > 0.05);Seven days after operation,there was no statistical difference in QoR-40 scores among the four groups(A,B,C and D).(5)Comparison of VAS scores: Six hours after operation,there was no statistical difference in VAS scores among the four groups(P > 0.05);12 hours after operation,the VAS scores of group B,C and D were all lower than those of group A(P < 0.05),and those of group D were lower than those of group B and C(P < 0.05),and there was no statistical difference between the two groups(P > 0.05).Twenty-four hours after operation,the VAS scores of group B,C and D were lower than those of group A(P <0.05),and those of group D were lower than those of group B and C(P < 0.05),and there was no statistical difference between the two groups(P > 0.05).48 h after operation,there was no statistical difference in VAS scores between the four groups(P >0.05).(6)ROM comparison: Compared with this group before operation,there was no statistical difference between the four groups on the 7th day after operation(P > 0.05).There was no statistical difference in ROM among the four groups on the 7th postoperative day(P > 0.05).(7)Comparison of HSS score: Compared with this group before operation,there was no statistical difference in HSS score between the four groups on the 7th day after operation(P > 0.05).There was no significant difference in HSS scores between the four groups on the 7th postoperative day(P > 0.05).(8)Comparison of the incidence of PONV in patients: Compared with group A,B,C and D can significantly reduce the incidence of PONV in patients(P < 0.05),but there is no statistical difference among the three groups(P > 0.05).ConclusionTEAS can effectively control postoperative inflammatory reaction,and 2/100 Hz TEAS has the best anti-inflammatory effect.In addition,TEAS can effectively prevent PONV and improve the quality of patients’ postoperative recovery,but there is no difference in curative effect between different frequencies of TEAS,so further experiments are needed to verify the influence of different frequencies on the quality of recovery.Finally,TEAS did not promote the recovery of knee joint function. |
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