Effects Of Transcutaneous Acupoint Electrical Stimulation On Postoperative Sleep Quality And Postoperative Delirium In Elderly Patients With Frail Patients Undergoing Radical Gastrointestinal Tumor Surgery

Objective:To observe the effect of transcutaneous electrical acupoint stimulation on postoperative sleep quality and postoperative delirium in elderly patients with frail gastrointestinal tumors undergoing radical resection.Methods:We selected 60 elderly frail patients who underwent radical gastrointestinal tumor resection in our hospital,who were older than 65 years old and were evaluated as frail patients by FIRED frailty phenotype.According to the random number method,they were divided into two groups,the transcutaneous acupoint electrical stimulation group（TEAS）and the control group（group C）.Both groups underwent endotracheal intubation combined with general anesthesia.TEAS patients selected Shenmen,Neiguan,and Zusanli points for electrical stimulation 30 minutes before induction of anesthesia.After routine disinfection with a sterile cotton ball dipped in alcohol,electrode pads were attached and SDZ-Ⅱacupuncture instrument was used.（2/10Hz）,the width is 0.25ms,the intensity is 1～30m A,gradually increase to the patient’s maximum tolerance,and the electrodes are kept for electrical stimulation until the end of the operation.In the control group,electrodes were attached to the same acupoints,and SDZ-Ⅱacupuncture instrument was connected.There was no effective current output,and the electrodes were kept until the operation was completed.After 1-3 days after surgery,the patient was subjected to electrical stimulation at the same point of time during the operation every day at the same acupoints（Shenmen,Neiguan,Zusanli）before the operation for 30 minutes.In the control group,electrodes were attached to the same acupoints and connected to the acupuncture instrument.There was no effective current output.The electrodes were kept for 30 minutes.Before surgery,record the general statistical data of the patient’s gender,age,operation method,etc.,and use a simple intelligence status checklist.Results:There was no statistically significant difference in general statistical data such as gender,age,surgical method,and MMSE baseline score between the two groups.There were no statistically significant differences in operation time,anesthesia time,blood loss,and fluid supplementation between the two groups.Compared with group C,patients in TEAS group consumed less propofol and remifentanil after surgery（P<0.05）,and the consumption of sufentanil was similar（P>0.05）.Compared with group C,the number of PCIA pump self-controlled analgesia was significantly reduced in patients in the TEAS group at 0-8h,8-24h,and24-48h after surgery（P<0.05）.Compared with T₀ time,TEAS group and C group had higher AIS scores at T₁,T₂,and T₃ after operation（P<0.05）;at T₀,there was no significant difference in AIS score between TEAS group and C group（P>0.05）,compared with group C,TEAS group had lower AIS scores at T₁,T₂,and T₃（P<0.05）.Compared with group C,the incidence of POD,PONV and drowsiness in TEAS group was lower（P<0.05）.Two groups of patients.There was no significant difference in the incidence of postoperative respiratory depression（P>0.05）.Conclusion:Transcutaneous electrical acupoint stimulation can reduce the consumption of general anesthetics（propofol and remifentanil）in elderly patients undergoing radical gastrointestinal tumor resection,reduce the need for postoperative self-controlled intravenous analgesia pumps,and effectively relieve postoperative pain;And reduce the incidence of postoperative adverse reactions.The selection of Shenmen,Neiguan,and Zusanli acupoints in combination with acupoint electrical stimulation for elderly patients undergoing radical gastrointestinal tumor resection before and after surgery can improve the quality of postoperative sleep and reduce the incidence of POD.