Effect Of Transcutaneous Electrical Stimulation At Auricular Branch Of Vagus Nerve On The Pain And Inflammation After Daytime Laparoscopic Cholecystectomy

Objective: To observe the effect of transcutaneous electrical stimulation at auricular branch of vagus nerve on postoperative pain and inflammatory factors after daytime laparoscopic cholecystectomy.To discuss if transcutaneous electrical stimulation at auricular branch of vagus nerve can alleviate acute pain after laparoscopic cholecystectomy and inhibit inflammatory reaction.Methods: Patients undergoing laparoscopic cholecystectomy were randomly selecte d,including experimental group(group A,n=28 cases)and control group(group B,n=28 cases).Experimental group: under the external auditory canal and concha cavity of the right ear were placed a electrode respectively;Control group: in front of and behind of the right ear tragus placed a electrode respectively.During the operation,the patient’s vital signs(HR,BP)and the using status of vasoactive drugs were both recorded.After operation we need rec ord these items like postoperative analgesia score(visual analogue scale VAS and nu merical rating scale NRS)of immediately after extubation,10 minutes after extubation and 1h,6h,12 h,24h,30 h after urgery;additional times and dosage of postoperative analgesic drugs(Fentanyl citrate Injection);nausea and vomiting score.Two milliliter venous blood were extracted both preoperative and an hour and four hour after surgery,to detected the expression levels of inflammatory cytokines IL-6,IL-1,TNF-α,IL-10 by ELISA method.Results:Using visual analogue scale VAS and digital grade NRS to assess the degree of pain after surgery.In the experimental group(the cavity of auricular concha group,group A)and control group(the tragus group,group B),visual analog scores(VAS)and numerical rating scale(NRS)have significant difference at postoperative 1h,postoperative 6h,postoperative 12 h,the experimental group scores were lower than the control group.After surgery,additional times and dosage of postoperative analgesic drugs between A group and the B group were significantly different(mean± standard deviation were 3.429 ± 0.690 and 3.893 ± 0.629,p=0.011,respectively).There was no significant difference in the expression levels of IL-6,IL-1β,TNF-αand anti-inflammatory cytokine IL-10 between the two groups of patients before and after operation(1h and 4h),but there was a trend of inhibiting the expression of proinflammatory cytokines.Conclusion: Transcutaneous electrical stimulation at auricular branch of vagus nerve have improved effect in daytime laparoscopic cholecystectomy postoperative pain in a short time.It does not cause side effects like: tinnitus,hoarseness and throat discomfort.Transcutaneous electrical stimulation of auricular branch of vagus nerve can relieve pain after daytime laparoscopic cholecystectomy in a short time,and it does not cause side effects like: tinnitus,hoarseness and throat discomfort.Transcutaneous electrical stimulation at auricular branch of vagus nerve can be used as the auxiliary treatment of clinical pain.Percutaneous electrical stimulation at auricular branch of vagus nerve can inhibit the serum concentration of inflammatory cytokines after surgery.