Transcutaneous electrical acupoint stimulation in adult patients receiving gastrectomy/colorectal resection: A randomized controlled trial

doi:10.4240/wjgs.v15.i7.1474

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Randomized Controlled Trial

World J Gastrointest Surg. Jul 27, 2023; 15(7): 1474-1484
Published online Jul 27, 2023. doi: 10.4240/wjgs.v15.i7.1474

Transcutaneous electrical acupoint stimulation in adult patients receiving gastrectomy/colorectal resection: A randomized controlled trial

Yuan-Tao Hou, Yuan-Yuan Pan, Lei Wan, Wen-Sheng Zhao, Ying Luo, Qi Yan, Yi Zhang, Wei-Xin Zhang, Yun-Chang Mo, Lu-Ping Huang, Qin-Xue Dai, Dan-Yun Jia, Ai-Ming Yang, Hai-Yan An, An-Shi Wu, Ming Tian, Jian-Qiao Fang, Jun-Lu Wang, Yi Feng

Yuan-Tao Hou, Qi Yan, Yi Zhang, Wei-Xin Zhang, Hai-Yan An, Yi Feng, Department of Anesthesiology, Peking University People’s Hospital, Beijing 100044, China

Yuan-Yuan Pan, Yun-Chang Mo, Lu-Ping Huang, Qin-Xue Dai, Dan-Yun Jia, Jun-Lu Wang, Department of Anesthesiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China

Lei Wan, Ming Tian, Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

Wen-Sheng Zhao, Department of Pain Medicine, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital, Hangzhou 310003, Zhejiang Province, China

Ying Luo, An-Shi Wu, Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China

Ai-Ming Yang, Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China

Jian-Qiao Fang, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China

Yi Feng, Department of Pain Medicine, Peking University People’s Hospital, Beijing 100044, China

Yi Feng, Key Laboratory for Neuroscience, Ministry of Education/National Health Commission of China, Peking University, Beijing 100083, China

Author contributions: Feng Y, Wang JL, Fang JQ, Tian M, Wu AS, and An HY were responsible for conceptualization and methodology and are joint corresponding authors; Hou YT, Pan YY, Wan L, Zhao WS, Luo Y, and Yan Q collected the data, performed formal analysis, and contributed equally as first authors to this work; Feng Y was responsible for funding acquisition; Zhang Y, Zhang WX, Mo YC, Huang LP, Dai QX, Jia DY, and Yang AM were responsible for project administration; Hou YT wrote the original draft; Feng Y, Wang JL, Fang JQ, Tian M, and Wu AS reviewed and edited the manuscript; All authors read and approved the final manuscript.

Supported by National Basic Research Program of China (Project 973) from The Ministry of Science and Technology of the People's Republic of China, No. 2013CB531900.

Institutional review board statement: This trial was approved by the Ethics Committee of Peking University People’s Hospital on June 9, 2013 and by the Ethical Committees of all participating centers, No. 2013 (09).

Clinical trial registration statement: The trial was registered on the Chinese Clinical Trial Registry, No. ChiCTR-TRC-14004435.

Informed consent statement: Written informed consent was obtained from all participants.

Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.

Data sharing statement: No additional data are available.

CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.

Corresponding author: Yi Feng, MD, PhD, Professor, Department of Anesthesiology, Peking University People’s Hospital, No. 11 Xizhimen South Street, Beijing 100044, China. doctor_yifeng@sina.com

Received: November 23, 2022
Peer-review started: November 23, 2022
First decision: February 23, 2023
Revised: March 5, 2023
Accepted: May 8, 2023
Article in press: May 8, 2023
Published online: July 27, 2023
Processing time: 240 Days and 1.3 Hours

Abstract

BACKGROUND

Acupuncture promotes the recovery of gastrointestinal function and provides analgesia after major abdominal surgery. The effects of transcutaneous electrical acupoint stimulation (TEAS) remain unclear.

AIM

To explore the potential effects of TEAS on the recovery of gastrointestinal function after gastrectomy and colorectal resection.

METHODS

Patients scheduled for gastrectomy or colorectal resection were randomized at a 2:3:3:2 ratio to receive: (1) TEAS at maximum tolerable current for 30 min immediately prior to anesthesia induction and for the entire duration of surgery, plus two 30-min daily sessions for 3 consecutive days after surgery (perioperative TEAS group); (2) Preoperative and intraoperative TEAS only; (3) Preoperative and postoperative TEAS only; or (4) Sham stimulation. The primary outcome was the time from the end of surgery to the first bowel sound.

RESULTS

In total, 441 patients were randomized; 405 patients (58.4 ± 10.2 years of age; 247 males) received the planned surgery. The time to the first bowel sounds did not differ among the four groups (P = 0.90; log-rank test). On postoperative day 1, the rest pain scores differed significantly among the four groups (P = 0.04; Kruskal–Wallis test). Post hoc comparison using the Bonferroni test showed lower pain scores in the perioperative TEAS group (1.4 ± 1.2) than in the sham stimulation group (1.7 ± 1.1; P = 0.04). Surgical complications did not differ among the four groups.

CONCLUSION

TEAS provided analgesic effects in adult patients undergoing major abdominal surgery, and it can be added to clinical practice as a means of accelerating postoperative rehabilitation of these patients.

Keywords: Analgesia; Bowel function; Colorectal resection; Gastrectomy; Postoperative pain; Transcutaneous electrical acupoint stimulation

Core Tip: Transcutaneous electrical acupoint stimulation at an alternating 2/100-Hz frequency and maximum tolerable current to the bilateral Neiguan (P6), Hegu (LI4), Zusanli (ST36), and Sanyinjiao (SP6) did not promote functional recovery of the gastrointestinal tract after major abdominal surgery but alleviated postoperative pain.