Preventive Effect Of Transcutaneous Acupoint Electrical Stimulation With Different Time Duration On Postoperative Delirium In Elderly Patients With Gastrointestinal Tumors

Objective: To observe the preventive effect of transcutaneous electrical acupoint stimulation(TEAS)on early postoperative delirium(POD)in elderly patients with gastrointestinal cancer at different time duration and to infer the potential mechanism of TEAS preventing early POD.Methods: In this study,a total of 80 patients with gastrointestinal malignancies aged 65 years and over who were operated under general anesthesia were randomly divided into four groups according to the ratio of 1:1:1:1: sham electrode stimulation group(group C),pre-anesthesia stimulation group(group P),anesthesia induction to end of operation stimulation group(group A)and pre-anesthesia induction to end of operation stimulation group(group PA).A pre-anesthesia visit was carried out one night before the operation to record the general information of the patient such as sex and age,as well as the levels of serum C-reactive protein(CRP),choline esterase(Ch E)and other biological indicators at admission.On the day of operation,patients in each group were treated with TEAS with corresponding duration,dense-disperse wave and frequency of 2～100Hz.Serum CRP and liver function were measured in the morning 1 to 3 days after the operation.At 8 to 9o’clock every night,the confusion assessment method for the intensive care unit was used to assess whether the patient had delirium.The patient was also asked whether to recover gastrointestinal exhaust,and the serum CRP and Ch E levels in the morning test results were recorded.On the discharge day of the patient,the patient’s postoperative exhaust time,postoperative hospitalization time and the occurrence of adverse events during the postoperative hospitalization were recorded according to the medical record.Results: There was no significant difference in demographic characteristics,serum CRP,Ch E and other biological indicators,and operation-related information of the four groups(P>0.05).The incidence of early POD in group C was 35.00%;The number of patients with early POD in group P and group A decreased compared with group C,but there was no significant difference(P>0.05);The incidence of early POD in PA group was 5.00%,significantly lower than that in group C(P=0.0436).However,there was no significant difference in serum CRP and Ch E level between the four groups at each time point 1 to 3days after operation(P>0.05).The dosage of propofol consumed by patients in PA group was significantly lower than that of patients in C group(P=0.0288).The postoperative recovery time of patients in the PA group was significantly shorter than that in the C and P groups(P<0.0001 and 0.0464,respectively).Conclusion: TEAS from 30 minutes before anesthesia induction to the end of operation could effectively reduce the occurrence of early POD,while also reducing intraoperative propofol dosage and shortening postoperative recovery time.Other time courses could not significantly affect the incidence of early POD.