Application Of Transcutaneous Electrical Acupoint Stimulation In Enhanced Recovery After Surgery Of Patients Undergoing Laparoscopic Colorectal Cancer Resection:A Randomized Controlled Trial

ObjectiveTo observe the effect of transcutaneous electrical acupoint stimulation(TEAS)combined with transversus abdominis plane block(TAP)on the rapid recovery of patients after laparoscopic colorectal resection,and to provide reference for the clinical application of TEAS.Methods105 patients undergoing laparoscopic colorectal resection were randomly divided into three groups: control group(group A),group TAP(group B),TEAS compound TAP group(group C).In group C,Patients received electroacupuncture stimulation of bilateral Zu san li(ST36)at 30 min before anesthesia to the end of surgery.Groups of B and C underwent TAP block after induction of anesthesia.Perioperative anesthesia management of the 3 groups were performed according to the ERAS guidelines,and postoperative patient-controlled intravenous analgesia(PCIA)was used.Blood glucose values were recorded in three groups of patients after 1 hours of operation;The amount of remifentanil used in the three groups was observed and recorded,and the visual analogue scale(VAS)of the 4h,12 h,24h and 48 h after surgery in the two groups was recorded.The count of white blood cells(WBC)and the content of serum albumin(ALB)were recorded at first and third days after operation in three groups of patients.Moreover,postoperative anal exhaust time,postoperative feeding time,postoperative first ambulation time and postoperative hospital stay length were compared between the three groups.Results:There was no significant difference in age,height,weight,sex distribution and ASA classification between the three groups(P>0.05).There was no significant difference in the contrast of basic diseases such as hypertension,diabetes and COPD(P>0.05).There was no significant difference in the time of anesthesia,the time of operation,the amount of transfusion during the operation,the amount of bleeding and the amount of urine in the three groups(P>0.05).There was no significant difference in the number of cases of vasoactive drugs and atropine in the three groups(P>0.05).There was a significant difference in the dosage of remifentanil between the three groups(P<0.05),and the dosage of B and C in the two groups was significantly lower than that in the A group(P<0.05),but the difference between the two groups was not statistically significant(P>0.05).The difference of blood glucose between the three groups at the beginning of operation 1 hours was statistically significant(P<0.05),and blood sugar in two groups of B and C was lower than that in A group,the difference was statistically significant(P<0.05),but there was no significant difference between B group and C group in two groups(P>0.05).There was no significant difference between the three groups of MAP and HR groups(P>0.05).There was no significant difference in CO and SVV components between the three groups(P>0.05).The differences of WBC and ALB in the three groups were not statistically significant(P>0.05)on first days and third days after operation.There was no significant difference in the comparison of the cases of postoperative nausea and vomiting between the three groups(P>0.05).Three groups of patients with postoperative 4h ? postoperative 12 h,postoperative 24 h and postoperative 48 h scores of VAS was statistically significant difference(P<0.05).There was statistically significant difference in VAS scores between group B and group A in postoperative 4h,postoperative 12 h and postoperative 24h(P<0.05),but there was no significant difference between the two groups in VAS scores of 48 h after operation(P>0.05).C group and A group had statistically significant difference in postoperative4 h,postoperative 12 h,postoperative 24 h and postoperative 48 h VAS score(P<0.05),while C group and B group had only statistically significant difference in postoperative 48 h VAS score after surgery.The difference of the first time of anal exhaust time between the threegroups was statistically significant(P<0.05),and the difference between the two groups in group B and A was statistically significant(P<0.05).The anal exhaust time in group C was shorter than that in A group and B group(P<0.05).The difference was statistically significant in three groups of patients after the first feeding time between the two groups(P<0.05),B group and A group,and the difference between the two groups was statistically significant(P<0.05),C group and A group,and the difference between the two groups was statistically significant(P<0.05),C group and B group,but the difference between the two groups.Is not obvious(P>0.05).There was no significant difference in the time of postoperative ambulation and postoperative hospitalization between the three groups(P>0.05).ConclusionTEAS combined with TAP analgesia can shorten the recovery time of gastrointestinal function and promote postoperative rapid rehabilitation.TEAS combined TAP analgesia is superior to single TAP analgesia,which may help prolong the analgesic time of single TAP.