A Prospective Randomized Controlled Study Of The Effect Of Transcutaneous Electrical Acupoint Stimulation On Postoperative Gastrointestinal Function In Patients Undergoing Spinal Surgery

Objectives:To evaluate the effect of transcutaneous electrical acupoint stimulation(TEAS)on postoperative gastrointestinal function in patients undergoing spinal surgery.Methods:Fifty patients of both sexes,aged 50-75 yr,with body mass index of18.5-28 kg/m~2,of American Society of Anesthesiologists physical status I-III,undergoing elective spinal surgery under general anesthesia,were divided into 2groups(n=25 each)by a random number table method:control group(group C)and group TEAS.In group C,stimulating electrodes were placed at the non-acupoint parts of the limbs,but no electrical stimulation was applied.In The group TEAS,the Neiguan(PC6),Hegu(L14),Zusanli(ST36),Shangjuxu(ST37)and Xiajuxu(ST39)were stimulated with a frequency of 2/100 Hz and disperse-dense waves.The intensity of stimulation was the maximum current that patients could tolerate.The treatment was performed once a day for a total of 8 times before induction of anesthesia and 7 days after operation.The treatment duration was 30 min each time.Time to first flatus and defecation,time to first bowel motion and incidence of abdominal distension were recorded.Then,serum albumin levels before surgery and at day 1,3 and 7 after surgery,the number of serum albumin supplements,VAS score,Incidence and score of nausea and vomiting were recorded as well.Serum concentration of Substance P and cholecystokinin before surgery and 1 and 3 days after surgery was assessed using ELISA.Results:A total of 50 patients who underwent lumbar discectomy and spinal decompression with screw and rod system internal fixation were included,25 in the control group and 25 in the TEAS group.There were no significant differences in age,sex,height,weight,BMI,ASA grading,operative stage,operative time and blood transfusion volume between the control group and the TEAS group(n=25,P>0.05),Compared with the control group,time to first flatus and defecation,time to first bowel motion was significantly shortened while the incidence of abdominal distension was significantly decreased(P<0.01).There was no significant difference in serum albumin levels,the number of serum albumin supplements,VAS score,Incidence and score of nausea and vomiting,serum concentration of Substance P and cholecystokinin between the two groups(P>0.05).Conclusions:TEAS can improve postoperative gastrointestinal function in patients undergoing spinal surgery by shortening time to first flatus and defecation,time to first bowel motion as well as decreased the incidence of abdominal distension.