Effects of transcutaneous electrical acupoint stimulation on postoperative pulmonary complications in video‑assisted thoracic surgical lobectomy: a randomized controlled study

Abstract

Abstract Background Recent studies report that transcutaneous electrical acupoint stimulation (TEAS), a non-invasive and non-pharmacological adjunctive for perioperative rehabilitation, may improve respiratory function and reduce the incidence of postoperative pulmonary complications in patients undergoing video-assisted thoracic surgery (VATS).We studied the hypothesis that TEAS may improve inflammatory reaction,Oxygenation and post operative pulmonary complications(PPCs) in patients undergoing VATS lobectomy. Methods Data from 130 patients undergoing VATS lobectomy were analysed.All patients were randomized to two groups (TEAS group and Control group),and were managed using the same anaesthetic protocol.TEAS were performed from 30min before induction and during the operation at 2/100 Hz over acupoints Lieque and Hegu on the both side.Veinal blood was drawn for blood routine examination to count quantity of Neutrophil, Platelet and Lymphocyte and then to calculate two inflammatory indicators PLR and NLR at 5 time points.Mixed venous and arterial blood was drawn for measurement of shunt-fraction and dead-space at 3 time points.PPCs(following the ARISCAT study) during postoperative hospitalization were recorded. Results Among 130 patients,respiratory infection and pleural effusion were the most common complications.PPCs were less detected in TEAS group than Control group (12.5% vs. 27.3%, OR 2.44 [95% CI, 0.285–0.010]. At T2(Two Lung Ventilation after intubation 5 min),dead-space,and shunt-fraction were no difference between two groups,with the prolonged operation,TEAS group showed obvious advantages after acupoint stimulation,lower dead-space and shunt-fraction were detected in TEAS group(P < 0.001).NLR was lower in TEAS group,the difference was significant at T4(end of One Lung Ventilation,P＜0.001) and T5(first day after operation,P＜0.001),while PLR in there was difference at T5(P = 0.015).Furthermore,binary logistic regression model was built to analyses the correlation between PLR,NLR with PPCs respectively.Result shows PLR and NLR were meaningful in predicting postoperative lung complications as a risk factor. Conclusions The effect of TEAS during VATS lobectomy reduces the incidence of the PPCs recorded,attenuates the systemic inflammatory response and improve intraoperative oxygenation.PLR and NLR could be used as a risk factor to predict PPCs.