Effect Of Transcutaneous Electrical Acupoint Stimulation On Postoperative Sleep Quality In Elderly Patients Undergoing Laparoscopic Surgery

Objective: To observe the effect of transcutaneous electrical acupoint stimulation(TEAS)on postoperative sleep quality of elderly patients undergoing laparoscopic surgery.Methods:From September 2020 to December 2020,forty elderly patients undergoing elective laparoscopy under general anesthesia,aged 60-75 years,BMI 18～35 kg/m~2,ASA physical status Ⅱ or Ⅲ,randomly divided into 2groups using random number table: TEAS group(group T)and control group(group C),20 in each group.Patients in group T,received TEAS(disperse-dense waves,frequency 2/100 Hz)on acupoints Neiguan,Zusanli and Sanyinjiao on both sides starting from 30 minutes before induction of anesthesia until the end of surgery,and the intensity was the maximum current that could be tolerated.In group C,electrodes were pasted on the same acupoints before anesthesia induction,but no current stimulation was given.The general condition of the patients,the dosage of propofol and remifentanil,operation time and anesthesia time were recorded.The Pittsburgh Sleep Quality Index(PSQI)was measured and record in both groups before and after the operation on the first,and third days.Adverse reactions such as nausea,vomiting,delirium were recorded.VAS scoresat 6,24 and 72 hours after operation were recorded.The morning urinewas taken before operation and on the 1st and 3rd day after operation.The concentration of melatonin(MT)in urine was detected by enzymelinked immunosorbent assay(ELISA).Adverse reactions including nausea,vomiting and delirium were recorded within 72 hours after operation.Results: There were no statistically significant between the group T and group C in general information and intraoperative conditions(P>0.05).The intraoperative consumption of propofol were significantly lower in group T than in group C(P<0.05),and there was no significant difference in the dosage of remifentanil between the two groups(P>0.05).There was no significant difference in the PSQI score and the melatonin concentration in morning urine between the two groups before operation(P>0.05).Compared with group C,patients in group T showed significantly higher PSQI scores at 1,3 days after operation(P<0.05).Compared with preoperative,the PSQI score of the two groups was increase significantally on the 1st and 3rd days after operation(P<0.05).Compared with group C,the urinary MT concentration in group T was significantly increased on the 1st and 3rd days after operation(P<0.05).Compared with preoperative,the MT concentration in the two groups was significantly increased on the 1st and 3rd days after operation(P<0.05).Compared with group C,the VAS scores at 6 h and 24 h after operation in group T were significantly decreased(P<0.05).The VAS scores showed no significant difference between the two groups at 72 h after operation(P>0.05).Compared with group C,the incidence rate of postoperative nausea andvomiting was significant reduced(P<0.05).There was no significant difference between the two groups in the incidence rate of delirium(P>0.05).Conclusions: The sleep quality of the elderly decreased after laparoscopic surgery,and transcutaneous acupoint electrical stimulation can improve the sleep quality and regulated the level of MT.