Effect Of Transcutaneous Electrical Acupoint Stimulation Combined With Transversus Abdominis Plane Block On Postoperative Recovery In Elderly Patients Undergoing Laparoscopic Gastric Cancer Surgery: A Randomized Controlled Trial

Objective:This study assessed the influence of transcutaneous electrical acupoint stimulation（TEAS）combined with transversus abdominis plane block（TAPB）on the recovery of elderly patients undergoing laparoscopic gastric cancer surgery.Methods:Totally ninety patients（age≥60 years）undergoing laparoscopic gastric cancer surgery and ASA physical statusⅠ～Ⅲwere randomly divided into general anesthesia group（Group G）,TAPB group（Group NG）,and TEAS combined with TAPB group（Group NTG）.Patients in the NTG group received bilateral TEAS at the acupoints of PC6,LI4,and ST36 and TAPB.Patients in the NG group received bilateral TAPB.The quality of recovery（Qo R）was assessed using Qo R-15 questionnaire.The percentages of T-lymphocyte subsets（CD3⁺、CD4⁺、CD8⁺）were determined.Consumption of anaesthetics,extubation time,visual analog scale（VAS）scores,time of first postoperative ambulation and flatus,and postoperative adverse events were also recorded.Results:Qo R-15 scores on postoperative day（POD）3 and POD 7 were higher in the NTG group than in the G and NG groups（P<0.05）.On POD 1 and POD 3,the percentages of CD3⁺and CD4⁺T cells and the CD4⁺/CD8⁺ratio were higher and the percentage of CD8⁺T cells was lower in the NTG group than in the G and NG groups（P<0.05）.The mean arterial pressure（MAP）and heart rate（HR）at T₁and T₅were significantly lower in the NG and NTG groups（P<0.05）than in the G group.The MAPs and HRs at T₅were significantly lower in the NTG group than in the NG group（P<0.05）.Compared with the NG and G groups,the remifentanil consumption,PCIA pump press numbers and the incidence of postoperative nausea and vomiting（PONV）were lower,and extubation time and time of first postoperative flatus were shorter in the NTG group（P<0.05）.Compared with the G group,the VAS scores on POD 1 were lower in the NG group and those on POD 2 were lower in the NTG group（P<0.05）.Conclusion:The combination of TEAS and TAPB ameliorated postoperative pain,shorten the recovery time of gastrointestinal function,improved immune function,reduced the incidence of PONV,and effectively promoted postoperative recovery in elderly patients undergoing laparoscopic gastric cancer surgery.