Effects Of Multiple Perioperative Transcutaneous Auricular Vagus Nerve Stimulation On Early Postoperative Cognitive Function In Elderly Patient

Background Postoperative cognitive dysfunction is a common postoperative complication.a reversible and volatile acute disorder syndrome with brain dysfunction,studies have shown that central inflammation may be one of the causes.Cholinergic anti-inflammatory pathway is a mechanism found in recent years to regulate and inhibit inflammatory response,and autonomic nerve mainly monitors inflammatory stimulation and cytokine production in this system,so it plays an important role.The aim of this study was to activate cholinergic anti-inflammatory pathway by transcutaneous auricular vagus nerve stimulation to observe whether it can inhibit the inflammatory level of perioperative patients,reduce the damage of neuronal cells and improve the elderly patients Cognitive function,promote the rehabilitation of patients,and provide research basis for clinical application and theoretical research.ObjectiveTo observe and evaluate the clinical effect of multiple transcutaneous auricular vagus nerve stimulation on early postoperative cognitive dysfunction in elderly patients.MethodsA total of 120 elderly patients were randomly divided into three groups: taVNS group,false stimulation group and blank control group,30 cases per group.ta VNS group used used a low frequency pulse therapy instrument(G6805-2)in the distribution area of auricular vagus nerve,with a intensity of 1 m A,frequency of 20～30 Hz,a pulse duration of 1 and a stimulation interval of 10 s.From the day before surgery to three days after surgery,once a day,30 min,each time a total of 4 times of treatment.The false stimulation group was subjected to electrical stimulation with the same parameters,and the stimulation position was the distribution area of auricle non-magic nerve.The blank control group did not do any treatment.the montreal cognitive assessment scale(MOCA)was performed one day before,1,3,and 7 d postoperatively to measure cognitive function,and the serum neuron-specific enolase(NSE),S100β,TNFα、IL-6,and IL-1β levels of the patients were measured with venous blood.ResultsThe mean MOCA of 1,3,and 7 d after 1 operation was significantly higher than that of false stimulation group and blank control group.The NSE、S100β、TNFα、IL-6、IL-1β five laboratory indexes of the ta VNS group were significantly lower than those of the sham-stimulated group and the blank control group 1d after operation and 3d after operation.ConclusionMultiple percutaneous auricular nerve stimulation can relieve early cognitive impairment in elderly patients.