Effects of Transcutaneous Electrical Acupoint Stimulation on the Postoperative Sleep Quality and Pain of Patients After Video-Assisted Thoracoscopic Surgery: A Prospective, Randomized Controlled Trial

Abstract

Objective

Postoperative sleep disturbances have serious adverse effects on postoperative outcomes. Our paper aimed to observe the effect of using transcutaneous electrical acupoint stimulation (TEAS) on sleep quality and complications after surgery in patients undergoing selective video-assisted thoracoscopic surgery.

Patients and Methods

Eighty-five patients were divided into the TEAS group or the control group randomly. Thirty minutes of TEAS treatment was performed on TEAS group at the following time points: the first night before surgery, at the end of surgery, and before sleeping on the second and third nights after surgery. The Portable Sleep Monitor (PSM) was performed to determine the sleep quality of the two nights before the operation (Sleep preop 2 and Sleep preop 1) and the first and third night after surgery (Sleep POD 1 and Sleep POD 3). The visual analog scale (VAS) was performed to evaluate pain scores after surgery and the Athens Insomnia Scale (AIS) was used for evaluating subjective sleep quality.

Results

Participants in the TEAS group had a lower AIS score and higher sleep efficiency at each time point except Sleep preop 2. Participants in the TEAS group showed significantly higher proportion of each sleep stage during Sleep-preop 1, Sleep POD 1, and Sleep POD 3. Patients in the TEAS group had significantly lower VAS scores at 2, 4, and 6 h during the first 24 h after surgery. The incidence of nausea and vomiting and dizziness in the control group was statistically higher than in the TEAS group.

Conclusion

Patients usually have sleep disturbances after video-assisted thoracoscopic surgery, such as decreased distribution of each sleep stage, lower sleep efficiency, and higher AIS score. Undergoing TEAS treatment perioperatively can improve sleep quality, and effectively promote the postoperative analgesic effect and alleviate postoperative complications.

Keywords:

• acupoints
• general anesthesia
• pain
• sleep quality
• transcutaneous electrical acupoint stimulation

Data Sharing Statement

The individual deidentified participant data in our study could be shared with readers. Readers can obtain the data by emailing the corresponding author ([email protected]). We did not include specific data and documents from previous reports in our study. All the data in our study are available for 10 years.

Acknowledgments

The authors would like to thank Raymond C. Koehler, MD, Ph.D., from the Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins, University, Baltimore, MD, USA, and Dr. Weifeng Song, MD, Ph.D., from the Department of Anesthesiology and Perioperative Medicine, School of Medicine, the University of Alabama at Birmingham, Birmingham, AL, USA, for their discussion and advice on this study.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work. Bijia Song and Yuanyuan Chang contributed equally to the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

The present study was funded by the Joint Plan of Key R&D of Liaoning Provincial Science and Technology Department (2020JH2/10300123) and the Support Plan for Innovative Talents in Liaoning Higher Education Institution (grant no. 201834).