Journal of pain research · 2025
Auricular Plaster Therapy for Preoperative Anxiety in Major Surgery: A Prospective Matched-Cohort Study of Total Knee Arthroplasty and Pancreaticoduodenectomy Patients.
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Mi Qindong, Shao Qianqian, Bao Fei, Zhao Xiaolong, Zan Defang, Liu Yuhao, Wang Weibin
Аннотация
OBJECTIVE: To investigate the association of auricular plaster therapy (AP) with preoperative anxiety in patients undergoing total knee arthroplasty (TKA) and pancreaticoduodenectomy (Whipple).
METHODS: A prospective matched-cohort observational study was conducted at Peking Union Medical College Hospital from March 2024 to May 2025. The primary outcome was Perioperative Anxiety Scale-7 (PAS-7) scores at different preoperative timepoints. Secondary outcomes included modified Pittsburgh Sleep Quality Index (M-PSQI), satisfaction visual analog scale (VAS-satisfaction), intraoperative blood loss, postoperative VAS-pain scores, Self-Rating Anxiety Scale (SAS) scores, and incidence of delirium.
RESULTS: A total of 168 patients completed the study, and 98 patients (49 matched pairs) were included in the final analysis. The results revealed that auricular plaster (AP) therapy was significantly associated with reduced preoperative anxiety scores. Specifically, the AP exposed group demonstrated substantially lower median PAS-7 scores at both 12±2 hours before surgery (T2) and 2 hours before surgery (T3), with median differences of -4.00 points and -5.00 points, respectively (both p < 0.001). Generalized Estimating Equations further confirmed a significant group × time interaction effect (Wald χ2 = 44.73, p < 0.001), indicating a favorable association between AP therapy and attenuated anxiety progression. Similarly, AP therapy was significantly associated with improved perioperative sleep quality. The AP exposed group showed superior M-PSQI scores at T2 and at 72±2 hours postoperatively (T4), with a median difference of -4.00 points at T2 and a mean difference of -3.27 points at T4 (both p < 0.001). This was supported by a significant cumulative trend (Wald χ2 = 30.44, p < 0.001). Furthermore, the AP exposed group was associated with more favorable postoperative outcomes, including significantly lower VAS pain scores (mean difference: -1.00, p < 0.001) and SAS scores (mean difference: -4.02, p = 0.012). Multivariable regression identified treatment allocation as a key predictor of PAS-7 scores, with the model demonstrating moderate goodness-of-fit (adjusted R2 = 0.50). No significant associations were observed between AP therapy and intraoperative blood loss, postoperative length of stay, or incidence of delirium. The AP exposed group exhibited a lower incidence of adverse events (10.2% vs 16.4%), with only three cases of mild local reactions reported, suggesting an acceptable safety profile.
CONCLUSION: In this observational study, AP was associated with reduced preoperative anxiety and improved sleep quality and may contribute to optimized postoperative recovery through its cumulative effects. Larger randomized controlled trials are needed to establish causality.
METHODS: A prospective matched-cohort observational study was conducted at Peking Union Medical College Hospital from March 2024 to May 2025. The primary outcome was Perioperative Anxiety Scale-7 (PAS-7) scores at different preoperative timepoints. Secondary outcomes included modified Pittsburgh Sleep Quality Index (M-PSQI), satisfaction visual analog scale (VAS-satisfaction), intraoperative blood loss, postoperative VAS-pain scores, Self-Rating Anxiety Scale (SAS) scores, and incidence of delirium.
RESULTS: A total of 168 patients completed the study, and 98 patients (49 matched pairs) were included in the final analysis. The results revealed that auricular plaster (AP) therapy was significantly associated with reduced preoperative anxiety scores. Specifically, the AP exposed group demonstrated substantially lower median PAS-7 scores at both 12±2 hours before surgery (T2) and 2 hours before surgery (T3), with median differences of -4.00 points and -5.00 points, respectively (both p < 0.001). Generalized Estimating Equations further confirmed a significant group × time interaction effect (Wald χ2 = 44.73, p < 0.001), indicating a favorable association between AP therapy and attenuated anxiety progression. Similarly, AP therapy was significantly associated with improved perioperative sleep quality. The AP exposed group showed superior M-PSQI scores at T2 and at 72±2 hours postoperatively (T4), with a median difference of -4.00 points at T2 and a mean difference of -3.27 points at T4 (both p < 0.001). This was supported by a significant cumulative trend (Wald χ2 = 30.44, p < 0.001). Furthermore, the AP exposed group was associated with more favorable postoperative outcomes, including significantly lower VAS pain scores (mean difference: -1.00, p < 0.001) and SAS scores (mean difference: -4.02, p = 0.012). Multivariable regression identified treatment allocation as a key predictor of PAS-7 scores, with the model demonstrating moderate goodness-of-fit (adjusted R2 = 0.50). No significant associations were observed between AP therapy and intraoperative blood loss, postoperative length of stay, or incidence of delirium. The AP exposed group exhibited a lower incidence of adverse events (10.2% vs 16.4%), with only three cases of mild local reactions reported, suggesting an acceptable safety profile.
CONCLUSION: In this observational study, AP was associated with reduced preoperative anxiety and improved sleep quality and may contribute to optimized postoperative recovery through its cumulative effects. Larger randomized controlled trials are needed to establish causality.