Effect Of Transcutaneous Electrical Acupoint Stimulation On Perioperative Anxiety Of Patients Undergoing Breast Cancer Surgery

Objective To evaluate the effect of transcutaneous electrical acupoint stimulation(TEAS)on perioperative anxiety of patients undergoing modified radical mastectomy.Methods Eighty-four female patients with the anxiety subscale score of HADS ≥8,who were scheduled for modified radical mastectomy were selected.They are aged 18~65 years,with a BMI of 18.5-28.0 kg/m2 and ASA physical status of I or II level.84 female patients were randomly divided into two groups: the control group(group C,n=42)and the TEAS group(group T,n=42).For patients in group T,TEAS was performed once on the day before the operation and once before the induction of anesthesia on the day of the operation.EX-HN3 and PC6,PC8,and ST36 on the operated side were selected as the main acupoints.The TEAS was conducted with a frequency of 2/100 Hz and waveform of disperse-dense wave,of which the intensity was the maximum current intensity that could be tolerated by the patient.Each TEAS lasted for 30 minutes.For patients in group C,electrodes were pasted at the same acupoints as in group T but without electric current.Both groups of patients received combined intravenous-inhalational general anesthesia,which was maintained by target-controlled infusion of propofol and remifentanil.HADS was used to evaluate the patients’ anxiety and depression scores and incidence before the second TEAS on the day of operation and one day,3 days,and 3 months after operation.The Qo R-15 scale was adopted to evaluate the recovery quality of patients before the first TEAS and 3 days and 3 months after operation.Before the first TEAS,the 3rd day after operation, the 3rd month after operation,and the 3rd month after operation,the VAS scores at rest and cough and the percentage of pain occurrence were recorded.The patients’ incidence of neuropathic pain was followed up by telephone with LANSS scale after 3 months after operation.The peripheral venous blood of patients was sampled before and at the end of operation for the concentration determination of serum TNF-α,IL-6,and IL-10.The dosage of propofol and remifentanil during the operation,the time of laryngeal mask removal,and the incidence of postoperative complications were recorded.Results There was no statistically significant difference in general information,including age,ASA physical status,BMI,breast mass location,anesthesia time and operation time between the two groups(P > 0.05).Compared with group C,the incidence of anxiety in group T was lower(P<0.05)before the second TEAS on the day of operation and 1 day and 3 days after operation.Meanwhile,the Qo R-15 scale scores in group T were higher(P<0.05)after 3 days after operation.There was no statistically significant difference between the two groups in the incidence of anxiety and the Qo R-15 scale scores after 3 months after operation.Compared with group C,in group T the VAS score at rest and coughing was lower(P < 0.01),and the incidence of pain was lower(P < 0.01).The incidence of neuropathic pain after 3 months after operation was 21.4% in group C and 9.5% in group T,but the difference was not statistically significant.Compared with group C,the concentration of serum IL-6 in patients of group T decreased(P<0.05),and the concentration of IL-10 increased(P<0.01)at the end of the operation,while there was no statistically significant difference in TNF-α concentration.Compared with group C,patients in group T had reduced doses of remifentanil and propofol(P<0.05)and shorter mask removal time(P<0.05).The incidence of postoperative complications such as nausea and vomiting,remedial analgesia,constipation,fever and subcutaneous effusion was not statistically significant in the two groups.Conclusion TEAS in patients undergoing modified radical breast cancer surgery with anxiety symptoms can reduce the incidence of anxiety and improve the quality of early postoperative recovery in breast cancer patients...