Effect of transcutaneous electrical acupoint stimulation on postoperative delirium in frail elderly patients / 中华麻醉学杂志

ABSTRACT

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on postoperative delirium (POD) in frail elderly patients.Methods:Sixty frail elderly patients of both sexes, aged 65-80 yr, with body mass index of 18.5-30.0 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with preoperative Fried frailty phenotype scale≥3, were divided into 2 groups ( n=30 each) using a random number table method: control group (group C) and TEAS group.In group TEAS, patients received TEAS of Shenmen, Neiguan and Zusanli acupoints starting from 30 min before anesthesia induction until the end of surgery.The frequency was 2/100 Hz, wave length was 0.25 ms and the intensity was maintained at about 1-30 mA according to the current that could be tolerated.The same acupoints were continuously stimulated for 30 min at 24, 48 and 72 h after operation.Electroacupuncture was performed for 30 min at the points 4 cm lateral to the same acupoints in group C. The occurrence of POD was evaluated by Confusion Assessment Method at 1-7 days after surgery.The intraoperative consumption of propofol, remifentanil and sufentanil, the effective pressing times of patient-controlled intravenous analgesia (PCIA) pump, the requirement for rescue analgesia at 0-8 h (T 1), 8-24 h (T 2) and 24-48 h (T 3) after operation and the development of rescue analgesia, POD, postoperative nausea and vomiting (PONV) and somnolence after operation were recorded. Results:Compared with group C, requirement for rescue analgesia and the incidence of POD, PONV and somnolence after operation were significantly decreased, and intraoperative consumption of propofol and remifentanil and the postoperative effective pressing times of PCIA at T 1-3 were decreased in group TEAS ( P<0.05). Conclusion:TEAS can reduce the occurrence of POD in frail elderly patients.