Objective To observe the effects of perioperative transcutaneous electrical acupoint stimulation (TEAS) on postoperative gastrointestinal dysfunction (PGID) and quality of postoperative recovery in patients undergoing gynecologic laparoscopic surgery.
Methods Sixty-six patients, aged 18-64 years, BMI 18-30 kg/m2, ASA physical status Ⅰ or Ⅱ, were selected for gynecologic laparoscopic surgery under general anesthesia by laryngeal mask. The patients were divided into two groups by using the randomized number table method: TEAS group (group T) and control group (group C), 33 patients in each group. In group T, TEAS was performed at bilateral Zusanli acupoints, upper Giuhu acupoints, Neiguan acupoints, and Sanyinjiao acupoints 30 minutes before anesthesia induction, 1 day and 2 days after operation, each time last for 30 minutes, and electrode tablets were applied at the same time and the same acupoints without stimulation in group C. The intake, feeling nauseated, emesis, exam, and duration of symptoms scoring system (I-FEED) scores were recorded 3 days after operation. The time of the first postoperative anal exhaust, the time of the first postoperative defecation, and the time of the recovery of bowel sounds were recorded. Nausea and vomiting, abdominal pain and distension VAS scores 2, 6, and 12 hours after operation were recorded. Plasma gastrin and gastrin concentrations were recorded 1 day before operation and 2 days after operation. The QoR-15 score, insomnia severity index (ISI) score, and the incidence of postoperative sleep disturbance (POSD) were recorded 1 day before operation, 1 day and 2 days after operation, and 1 month after operation. The duration of surgery, time of anesthesia, time of laryngeal mask removal, intraoperative fluid infusion, bleeding, and urine output were recorded.
Results Compared with group C, I-FEED score, PGID incidence, postoperative nausea and vomiting, abdominal pain and distension VAS scores 2, 6, and 12 hours after operation, concentrations of plasma gastrokinetic and gastrin 2 days after operation, ISI scores, and the incidence of POSD 1 day and 2 days after operation were significantly decreased (P < 0.05), the time of first postoperative anal exhaust, the time of first postoperative defecation, and time of recovery of bowel sounds were significantly shortened (P < 0.05), QoR-15 scores were significantly increased 1 day and 2 days after operation in group T (P < 0.05).
Conclusion Perioperative TEAS can reduce the incidence of PGID in gynecologic laparoscopic surgery patients, reduce the degree of nausea and vomiting and abdominal pain and distension, shorten the time of the first postoperative anal exhanst, the time of the first postoperative defecation and the time of the recovery of the bowel sounds, elevate plasma gastrin and gastrin concentrations, and improve the quality of postoperative recovery． |
