The Effect Of Transcutaneous Electric Acupoint Stimulation Of Shenmen And Neiguan Points On Sleep Quality And Postoperative Delirium In Elderly Patients Undergoing Hip Replacement

Objective:To explore the effect of transcutaneous acupoint electrical stimulation of Shenmen and Neiguan Points on sleep quality and postoperative delirium in elderly patients undergoing hip fracture.Methods:102 elderly patients with hip replacement in our hospital were randomly divided into test group(T Group)and control group(C group),50 cases in T group and 52 cases in C group.The mental state was assessed by MMSE cognitive function by CAM,the subjects were assessed by Pittsburgh sleep quality index(PSQI),sleep monitoring bracelet and visual analog scale(VAS).In group T,both Shenmen and Neiguan acupoints were stimulated by transcutaneous acupoints 30 minutes before operation,18:00 on the day of operation,18:00 on the first day after operation and 18:00 on the second day after operation;in group C,the acupoint electric stimulator was connected,but it was not electrified.The gender,age,weight,ASA,anesthesia mode,operation mode,blood loss and operation time of the two groups were observed and recorded;VAS score(preoperative,postoperative day,postoperative 24 hours,postoperative 48 hours),MMSE and PSQI scores(72 hours before and after operation),Cam score(preoperative,postoperative 24 hours,postoperative 48 hours,postoperative 72 hours),Objective sleep was monitored by hand ring(one night before operation,the night after operation,the first night after operation and the second night after operation).Results:(1)There was no significant difference in gender,age,weight,ASA,anesthesia mode,operation mode,blood loss,operation time and VAS score between the two groups(P > 0.05).(2)MMSE score before and after operation was statistically significant(P<0.05),but there was nosignificant difference between the groups(P>0.05).(3)There was no significant difference in PSQI score between the two groups before operation(P > 0.05).The score of T group(11.14 ± 2.21)was lower than that of C group(12.65 ± 2.37)72 hours after operation,and the difference was statistically significant(P< 0.05).(4)There was no significant difference in the objective sleep index of hand ring monitoring before operation(P> 0.05);the length of deep sleep on the day after operation decreased to group t(1.01 ± 0.73)h and group C(0.93 ± 0.67)h,the difference was statistically significant(P < 0.05);after the first day after operation,the length of sleep and the length of deep sleep showed an upward trend,and the change range was statistically significant(P <0.05).(5)There was no significant difference between the two groups in preoperative cam score(P > 0.05).The score of the two groups increased significantly from preoperative to the first day after operation,and then decreased;there was statistical difference in the change range of the measured value of the two groups at each time point(P < 0.05).(6)13cases(12.74%)in the two groups developed delirium 1-3 days after operation,10 cases(19.23%)in group C and 3 cases(6.0%)in group T,The incidence of delirium in group C was significantly higher than that in group T(P<0.05).Conclusion:transcutaneous electrical stimulation of Neiguan and She nmen points can improve sleep and reduce the incidence of postoperative delirium.