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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
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.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ 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
ARTICLE HIGHLIGHTS
Research background
Postoperative ileus delays patient recovery. Acupuncture can accelerate the recovery of gastrointestinal (GI) function after abdominal surgery; however, the effect of transcutaneous electrical acupoint stimulation (TEAS) is unknown.
Research motivation
The effective stimulation paradigm of TEAS treatment for postoperative GI function remains unknown since most studies on perioperative TEAS treatment have been relatively underpowered, and the majority of previous studies were from a single center, with limited external validity.
Research objectives
To explore the potential effects of TEAS on the recovery of GI function and its analgesic effects in patients undergoing gastrectomy or colorectal resection.
Research methods
The 441 patients were randomized; 405 actually received surgeries (58.4 ± 10.2 years of age; 247 men): 83 in the sham stimulation group; 118 in the perioperative TEAS group; 122 in the preoperative and intraoperative TEAS group; and 82 in the preoperative and postoperative TEAS group. The primary outcome was the time to the first bowel sound. Secondary outcomes included the time to first flatus, time to water intake, time to solid food tolerance, time to ambulation, postoperative numerical rating scale pain score, patient-controlled intravenous analgesia sufentanil dosage, rate and severity of postoperative nausea and vomiting, postoperative and preoperative quality of life assessments, and surgical complications.
Research results
The time to the first bowel sounds did not differ among the four groups (P = 0.90; log-rank test). The resting pain score on postoperative day 1 differed significantly among the four groups (P = 0.04; Kruskal-Wallis test). Subgroup analysis showed that compared with the sham stimulation group the perioperative TEAS group had significantly reduced resting pain score on postoperative day 1 (1.4 ± 1.2 vs 1.7 ± 1.1; P = 0.04; Bonferroni test).
Research conclusions
TEAS provided analgesic effects but did not promote GI function recovery in adult patients undergoing gastrectomy or colorectal resection. This is the first large-sample multicenter randomized controlled trial to explore the treatment effects of TEAS on bowel function recovery after major abdominal surgery.
Research perspectives
Future research should focus on different stimulation frequencies and acupoints for the treatment effects of TEAS as well as its comparison with acupuncture.
