A Randomized Controlled Study On The Effect Of Transcutaneous Electrical Acupoint Stimulation In The Period Of Day From 7am To 9am On Gastrointestinal Function In Middle-aged And Elderly Patients After Lumbar Operation Under General Anesthesia

Objective: Based on the theory of midnight-noon ebb-flow in traditional Chinese medicine(TCM),investigating the effect of transcutaneous electrical stimulation in Chenshi(the period of day from 7am to 9am)of Stomach Meridian of Foot-Yangming,St Acupoints on the recovery of gastrointestinal function in middle-aged and elderly patients undergoing lumbar spine surgery under general anesthesia,in order to provide a new way to solve the problem of gastrointestinal dysfunction,accelerate the postoperative rehabilitation and accelerate the process of enhanced recovery after surgery.Methods:In this study,120 middle-aged and elderly patients undergoing lumbar spine surgery under general anesthesia were randomly divided into blank control group,sham-stimulation Group,non-Chenshi group and Chenshi group,with 30 cases in each group.The patients in the blank control group were treated with routine therapy in the department after operation,and the nurses in the department applied traditional Chinese medicine to Shenque(CV6)and Tianshu(ST 25)according to the requirements of the department and applied traditional Chinese medicine acupoint application to Shenque(CV 6),bilateral Tianshu(ST 25),One-sided Zusanli(ST 36).This group does not paste electrode,without point electrical stimulation.In the sham-stimulation group,on the basis of routine treatment,the electrodes were pasted on acupoints at 7am to 9am.The acupoints were selected as Shangjuxu(ST37),Zusanli(ST 36)and Tianshu(ST 25)points on the Stomach Meridian of Foot-Yangming,and the power supply of transcutaneous acupoint electrical stimulator was activated,without electrical stimulation was performed for30 min for 3 days.In the non-Chenshi group,electrodes were applied to the same points at non-Chenshi(time beyond the period of day from 7am to 9am),and transcutaneous electrical stimulation of the points was performed.The waveform was dense wave,the stimulation frequency was 2 times per second,and the stimulation intensity was 2-100 Hz.The operation in the Chenshi group was the same as that in the non-Chenshi group,and the time was selected as the period of the day from 7am to 9am.Perioperative data were recorded: age,sex,body mass index(BMI),ASA grade,preoperative and intraoperative fluid replacement,gastrin value on the fourth day after operation,time of first exhaust,time of first defecation and recovery time of bowel sounds,the incidence of nausea and vomiting,the frequency of nausea and vomiting,and the abdominal distension score.Results:(1)There was no statistical difference in age,sex,body mass index(BMI),duration of anesthesia,preoperative and intraoperative fluid replacement between the blank control group,the sham stimulation group,the non-Chenshi group and the Chenshi group,and the baseline balance was comparable.(2)The mean value of gastrin on the fourth day after operation in Chenshi group was higher than that in other groups,with statistical difference.(3)The time of first exhaust was shorter in the Chenshi group than in the other groups.The time of first defecation in the Chenshi group was shorter than that in the other groups,and there was no significant difference between the Chenshi group and the non-Chenshi group(P = 0.955).The recovery time of bowel sounds in the Chenshi group was significantly shorter than that in the other groups.(4)The incidence of postoperative nausea and vomiting in the Chenshi group was significantly lower than that in the other three groups,and the abdominal distension score in the Chenshi group was significantly lower than that in the non-Chenshi group,the blank control group and the sham-stimulation group and there was statistical significance.Conclusion:Chenshi transcutaneous acupoint electrical stimulation has a good promoting effect on the recovery of gastrointestinal function in middle-aged and elderly patients after lumbar surgery under general anesthesia.It can increase the secretion of gastrin in patients,promote gastrointestinal peristalsis,significantly shorten the recovery time of postoperative bowel sounds and the time of first exhaust and first defecation,reduce the frequency of postoperative nausea and vomiting,reduce the score of postoperative abdominal distension,and promote the recovery of gastrointestinal function of patients.