A total of 108 women who underwent CS were randomized to receive TEA or sham-TEA.
Sample Count
108
Age
≥18
Control
Sham
sham-TEA(n=54)
Experiment
TEA(n=54)
Indicator
Time of first flatusTime of first defecationBristol stool form scale(BSFS) of the first stoolNumber of SBMs within four days after CSUse of glycerin enema during defecationTime of ambulationTime of resuming semifluidVisual analog scale(VAS)Postoperative GI symptomsElectrogastrogram(EGG)Electrocardiogram(ECG)TNF-αIL-6
Auxiliary Medication
For anesthesia, 100 mg of 2% lidocaine and 10 mg of 0.5% ropivacaine were used. As a routine for all patients, 5 mg of tropisetron was given during surgery to prevent nausea and vomiting; whereas 5 mg of pethidine was given 30 min after surgery to relieve incision pain. An epidural patient-controlled analgesic (100mL of 0.1% ropivacaine plus 2 μg/mL dex- medetomidine) was given according to the patient’s willingness.
Stimulation Method
TEAS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
SNM-FDC01
Ningbo Maida Medical Device, Inc., Ningbo, China
25 Hz
-
2-10 mA
TEA atST36 or sham-TEA at non-acupoints was performed for one hour.
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
-
-
-
Description Two watch-size digital stimulators (SNM-FDC01; Ningbo Maida Medical Device Inc., Ningbo, China) were used for bilateral stimulation with following parameters: a train on-time of 2 sec and off-time of 3 sec, pulse width of 0.5 msec, pulse frequency of 25 Hz and amplitude of 2–10 mA (based on the tolerable level of the subject) (see Fig. 1).
Anesthesia Method
GA
Contraindications
Allergic to skin preparation
Effector
TEA enhanced postoperative recovery associated with lower GI motility, reflected as a reduction in time of first flatus (p = 0.002) and time of first defecation (p < 0.001), an increase in the Bristol stool score (p < 0.001) and the number of SBMs (p < 0.001) in comparison with sham-TEA. TEA reduced symptoms associated with upper GI motility, including a reduction in time to resume semifluid (p = 0.008), and the total score of loss of appetite (p = 0.003) and belching (p = 0.038) from POD1 to POD3. Physiologically, TEA but not sham-TEA increased the percentage of normal gastric slow waves on POD4 compared with POD0 (p = 0.001). TEA reduced the visual analogue scale (VAS) pain score from POD1 to POD3 (p < 0.001). TEA but not sham-TEA increased vagal activity (p = 0.013) and decreased sympathetic activity (p = 0.013) on POD4 compared with POD0. Two factors were found to be independent predictors of shortened time of the first defecation: the use of TEA and a shorter surgical duration. Needless non-invasive TEA at ST36 is effective in promoting both lower and upper GI symptoms after CS by enhancing vagal and suppressing sympathetic activities.
Effects and Mechanisms of Transcutaneous Electrical Acustimulation on Postoperative Recovery After Elective Cesarean Section.
Abstract
OBJECTIVES: To explore the effects and mechanisms of transcutaneous electrical acustimulation (TEA) on postoperative recovery after cesarean section (CS). MATERIALS AND METHODS: A total of 108 women who underwent CS were randomized to receive TEA or sham-TEA. Four hours after CS, electrogastrogram (EGG) and electrocardiogram (ECG) were recorded for 30 min to assess gastric slow waves and autonomic functions, respectively. TEA at ST36 or sham-TEA at non-acupoints was performed for one hour right after recording ECG and EGG and then twice daily from postoperative days (POD) 1 to 3. In the morning of POD4, the EGG and ECG were recorded again for 30 min. RESULTS: TEA enhanced postoperative recovery associated with lower GI motility, reflected as a reduction in time of first flatus (p = 0.002) and time of first defecation (p < 0.001), an increase in the Bristol stool score (p < 0.001) and the number of SBMs (p < 0.001) in comparison with sham-TEA. TEA reduced symptoms associated with upper GI motility, including a reduction in time to resume semifluid (p = 0.008), and the total score of loss of appetite (p = 0.003) and belching (p = 0.038) from POD1 to POD3. Physiologically, TEA but not sham-TEA increased the percentage of normal gastric slow waves on POD4 compared with POD0 (p = 0.001). TEA reduced the visual analogue scale (VAS) pain score from POD1 to POD3 (p < 0.001). TEA but not sham-TEA increased vagal activity (p = 0.013) and decreased sympathetic activity (p = 0.013) on POD4 compared with POD0. Two factors were found to be independent predictors of shortened time of the first defecation: the use of TEA and a shorter surgical duration. CONCLUSIONS: Needleless non-invasive TEA at ST36 is effective in promoting both lower and upper GI symptoms after CS by enhancing vagal and suppressing sympathetic activities [Correction added on 23 June 2020, after first online publication: The first word of the preceded sentence has been corrected.]."
Souce
Neuromodulation. 2020 Aug;23(6):838-846. doi: 10.1111/ner.13178. Epub 2020 May 29.
