Effect of Electroacupuncture and Transcutaneous Electrical Acupoint Stimulation on Postoperative Delirium in Elderly Patients
WANG Qi,ZHOU Rui-ling,DING Ling-ling
Department of Anesthesiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China
Abstract:
Objective To investigate the effect of electroacupuncture and transcutaneous electrical acupoint stimulation on postoperative delirium in elderly patients. Methods A total of 276 elderly patients undergoing pedicle screw internal fixation under selective general anesthesia were randomly divided into electroacupuncture group (group EA), transcutaneous electrical acupoint stimulation group (group TA) and control group (group C), with 92 patients in each group. Before induction of anesthesia, group EA and group TA received electroacupuncture or transcutaneous electrical acupoint stimulation. Delirium was evaluated on the 1st and 5th day after operation. The neuron-specific enolase (NSE), S-100β protein (S-100β), superoxide dismutase (SOD), tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were detected on the 1st day before operation, the 1st day after operation and the 5th day after operation. Dosage of propofol and remifentanil, the scores of mini-mental state examination (MMSE) and visual analog scale (VAS) were recorded in three groups. Results Compared with group C, the incidence of delirium were decreased in group TA and EA (P < 0.01). Compared with group C, the scores of VAS were decreased, and the scores of MMSE were increased on the 1st and 5th day after operation in group TA and EA (P < 0.01). Compared with 1d before operation, the level of serum TNF-α, NSE, IL-1β and S-100β were increased and SOD decreased on the 1st and 5th day after operation in three groups (P< 0.01). Compared with group C, the level of serum TNF-α, NSE and IL-1β were decreased and SOD were increased on the 1st and 5th day after operation in groups TA and EA (P < 0 . 01 ). The dosage of propofol in groups TA and EA were lower than that in group C (P < 0.05). Conclusion Electroacupuncture and transcutaneous electrical acupoint stimulation can reduce the incidence of postoperative delirium, postoperative pain, in.ammation and oxidative stress response in elderly patients.
