Effects of Transcutaneous Electrical Acupoint Stimulation on Postoperative Cognitive Decline in Elderly Patients: A Pilot Study

Abstract

Background

Postoperative cognitive decline (POCD) in the old ages seriously delays the rapid recovery. Here, we aimed to investigate the effects of transcutaneous electrical acupoint stimulation (TEAS) against POCD in elderly patients undergoing laparoscopic radical colon cancer surgery, as well as the potential mechanism.

Methods

A prospective, single-center, parallel-group, randomized trial was designed. A total of 100 patients (age ≥65 years) undergoing laparoscopic radical resection of colon cancer were involved and randomly divided into TEAS (Group T) and control (Group C) groups. The patients in Group T were performed with percutaneous acupoint electrical stimulation in bilateral Hegu, Neiguan and Zusanli points from 30 minutes before anesthesia induction to the end of surgery. A Z-score based on Mini-Mental State Exam (MMSE) was used to assess the incidence of POCD. The levels of serum IL-6, hs-CRP, CGRP at 0 min before TEAS (T0), 1 h after beginning of surgery (T1) and the end of surgery (T2) were evaluated.

Results

Our data showed that the cumulative duration of POCD on postoperative day 2 and 3 in Group T was significantly decreased compared to Group C (P < 0.05). Compared with T0, the levels of serum IL-6, hs-CRP, and CGRP in both Group T and C were statistically elevated at T1 and T2 (P < 0.05). Moreover, the levels of serum IL-6 and hs-CRP were decreased, but the level of CGRP was increased in Group T compared to Group C at T1 and T2 (P < 0.05).

Conclusion

TEAS is associated with a lower cumulative duration of POCD in elderly patients undergoing laparoscopic radical colon cancer surgery, which may be related to the regulation of inflammatory factors and neuropeptides interacted with gut–brain axis.

Keywords:

• cognitive decline
• gut–brain axis
• transcutaneous electrical acupoint stimulation
• colon cancer
• elder

Acknowledgments

We would like to thank Limin Zhang, Zhaohui Liu and Yangyang Guo for their support of this project. This project was supported by the National Natural Science Foundation of China (81771134), Hebei Province technology Innovation guide Project Science and Technology Winter Olympics special project (19977790D), Hebei Provincial government funded the specialty capacity building and specialty leader training program.

Data Sharing Statement

The datasets generated during and/or analyzed during the current study will be available upon reasonable request from Cangzhou Central Hospital. Email: [email protected]; Telephone: [phone].

Ethical Approval

The study was approved by Cangzhou Central Hospital Ethics Committee (ethical register number: 2020-153-02). Trial Registration: ChiCTR2000040397.

Author Contributions

All authors made substantial contributions to the 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.

Disclosure

The authors report no conflicts of interest in this work.