Transcutaneous electrical acupoint stimulation accelerates postoperative gastrointestinal function recovery in patients undergoing non-gastrointestinal laparoscopic surgery: a randomized controlled trial.

BACKGROUND

and Purpose: Postoperative gastrointestinal dysfunction (POGD) is a significant complication following abdominal surgery and is characterized by delayed flatus and stool passage, postponed oral feeding, and dyspeptic symptoms. The study aimed to evaluate whether transcutaneous electrical acupoint stimulation (TEAS) accelerates gastrointestinal function recovery and reduces POGD-related complications after elective laparoscopic non-gastrointestinal surgery.

MATERIALS AND

METHODS

Patients scheduled for selective non-gastrointestinal laparoscopic surgery were randomized into the TEAS or sham-TEAS group. TEAS group patients were administered electrical stimulation at acupoints Zusanli (ST36), Neiguan (PC6), and Hegu (LI4) starting 30 min prior to anesthesia induction and continuing until surgery completion. Patients in the sham-TEAS group received a sham stimulus at the same acupoints, and no output current was delivered by disconnecting the device's output line. Our primary endpoint included the time to first flatus, whereas the secondary endpoints were the time to first defecation, postoperative nausea and vomiting (PONV) rate, length of hospital stay, hospital expenses, numeric rating scale (NRS) pain score, and incidence of postoperative complications.

RESULTS

A total of 587 patients were enrolled and assigned to the TEAS (n = 294) or sham-TEAS (n = 293) group between May 15, 2019, and October 18, 2021. Compared with the sham-TEAS group, the TEAS group had a significantly shorter time to first flatus (median [interquartile range (IQR)], 21.50 h [19.0-23.5 h] vs. 23.5 h [21.0-26.0 h]; p < 0.001) and time to first defecation (41.2 h [38.5-45.0 h] vs. 46.0 h [42.0-52.0 h]; p < 0.001). Additionally, the TEAS group showed lower rates of PONV (15% vs. 22.9%; p = 0.015) and abdominal distention (21.1% vs. 29.7%; p = 0.017), as well as lower NRS pain scores (median [IQR], 3 [2-3] vs. 3 [2-3.5]; p = 0.026). There were no significant differences in hospital stay length and hospitalization expenses.

CONCLUSION

TEAS accelerates gastrointestinal function recovery in patients undergoing laparoscopic non-gastrointestinal surgery, reducing PONV, abdominal distention and postoperative pain without increasing hospital stay or costs.