Transcutaneous electrical acupoint stimulation for preventing postoperative delirium in elderly patients: a systematic review and meta-analysis.

OBJECTIVE

To systematically evaluate the efficacy of transcutaneous electrical acupoint stimulation (TEAS) in preventing postoperative delirium (POD) in elderly patients undergoing various surgical procedures.

METHODS

A comprehensive literature search was conducted across multiple electronic databases to identify randomized controlled trials (RCTs) comparing TEAS with control interventions (sham or no stimulation) in patients aged >60 years undergoing surgery. The primary outcome was the incidence of POD within the first seven postoperative days. Meta-analysis was performed using RevMan software, calculating risk ratios (RR), mean differences (MD), or standard MD with 95% confidence intervals (CIs). The quality of evidence was assessed based on the Grading of Recommendations Assessment, Development, and Evaluation approach.

RESULTS

Twenty RCTs involving 2,290 patients (aged >60 years) were included. The overall incidence of POD was 5.6% in the TEAS group compared to 17.0% in the control group (RR 0.34, 95% CI 0.26-0.45). TEAS also significantly reduced CAM score (MD -1.01, 95% CI -1.98 to -0.04), propofol consumption (MD -35.59 mg, 95% CI -65.75 to -5.42), postoperative pain score (MD -0.60, 95% CI -1.02 to -0.18), and improved recovery quality (QoR-15 score: MD 23.76, 95% CI 21.72-25.80). The intervention appeared safe with no serious adverse events reported.

CONCLUSION

Perioperative TEAS application significantly reduces the risk of POD in elderly surgical patients. Its protective effects are potentially mediated through anti-inflammatory effects. TEAS represents a promising non-pharmacological intervention for POD prevention within enhanced recovery protocols.

SYSTEMATIC REVIEW REGISTRATION: CRD420251128976.