Effects Of Transcutaneous Electrical Acupoint Stimulation On Postoperative Cognitive Decline In Elderly Patients And Its Mechanism

Postoperative cognitive decline(POCD)is common in elderly patients,and is one of the common postoperative complications.Postoperative quality of life of patients is reduced,postoperative nursing difficulty is greatly increased,postoperative hospitalization time is significantly prolonged,and family economic burden is increased.Advanced age and major surgery are high-risk factors for POCD,and preventive or treatment measures for high-risk patients can reduce the incidence of POCD.Traditional Chinese medicine has unique advantages in preventing and treating diseases.Acupuncture has been a traditional Chinese medicine method for more than 2,000 years.It has a wide range of adaptability,rapid and significant curative effects,economic medical costs and few side effects.Transdermal acupoint electrical stimulation is an upgraded version of Traditional Chinese acupuncture,which has the advantage of non-invasive.This study investigated the effect of transcutaneous electrical acupoint stimulation on postoperative cognitive function of elderly patients undergoing radical colon cancer surgery.Part Ⅰ:Effects of transcutaneous electrical acupoint stimulation on postoperative cognitive function in elderly patients undergoing laparoscopic radical colon cancer surgeryObjective:Postoperative cognitive decline(POCD)is one of the important factors affecting the rapid recovery of elderly patients after surgery.Here,we aimed to investigate the effects of transcutaneous electrical acupoint stimulation(TEAS)against POCD in elderly patients undergoing laparoscopic radical resection of colon cancer.Methods:A prospective,single-center,parallel-group,randomized trial was designed.100 patients(age ≥ 65 years)undergoing laparoscopic radical resection of colon cancer were involved and randomly divided into TEAS group(Group T)and control group(Group C).After entering the operating room,patients in Group T were given TEAS at bilateral Hegu,Neiguan and Zusanli points,and anesthesia induction was performed after giving TEAS for 30min until the end of the operation.A Z-score based on Mini-Mental State Exam(MMSE)was used to assess the incidence of POCD.Results:Our data showed that the cumulative duration of POCD on postoperative day 2 and 3 in Group T was significantly decreased compared to Group C(P<0.05).Conclusion:TEAS is associated with a lower cumulative duration of POCD in elderly patients undergoing laparoscopic radical colon cancer surgery.Part Ⅱ:Possible mechanism of transcutaneous electrical acupoint stimulation to improve postoperative cognitive function in elderly patients undergoing radical colon cancer surgeryObjective:Postoperative cognitive decline increases the difficulty of postoperative nursing for elderly patients and is not conducive to postoperative recovery.Here,we aimed to investigate the effects of transcutaneous electrical acupoint stimulation(TEAS)against POCD in elderly patients undergoing laparoscopic radical colon cancer surgery,as well as the potential mechanism.Methods:A prospective,single-center,parallel-group,randomized trial was designed.100 patients(age ≥ 65 years)undergoing laparoscopic radical resection of colon cancer were involved and randomly divided into TEAS group(Group T)and control group(Group C).The patients in Group T were performed with percutaneous acupoint electrical stimulation in bilateral Hegu,Neiguan and Zusanli acupoints from 30 minutes before anesthesia induction to the end of surgery.The levels of serum IL-6,hs-CRP,CGRP at 0 min before TEAS(T0),1 h after the surgery began(T1)and the end of surgery(T2)were evaluated.Results:Our data showed that the levels of serum IL-6,hs-CRP,and CGRP in both Group T and C were statistically elevated at T1 and T2 compared with T0(P<0.05).Specifically,although the levels of IL-6 and hs-CRP were decreased,but the level of CGRP was increased in Group T compared to the control group at T1 and T2(P<0.05).Conclusion:TEAS is associated with a lower cumulative duration of POCD in elderly patients undergoing laparoscopic radical resection of colon cancer,the regulation of inflammatory factors and neuropeptides interacted with gut-brain axis may be mechanism-related.