Electroacupuncture in the treatment of gastrointestinal dysfunction after laparoscopic nephrectomy: a retrospective analysis.

Abstract

Background: Although the Enhanced Recovery After Surgery (ERAS) protocol has been optimised, postoperative gastrointestinal dysfunction (POGD) still significantly hampers recovery after laparoscopic nephrectomy, thus adding to the burden on the national healthcare system. We aimed to evaluate the efficiency of electroacupuncture (EA) in reducing the duration of POGD, while exploring the pertinent factors.

Methods: A total of 226 medical records of patients with POGD from January 1 to October 31, 2022, were collected and analyzed. They were administered the ERAS protocol for urology and divided into Early Acupuncture Group (Observation Group 1), Delayed Acupuncture Group (Observation Group 2), and Non-Acupuncture Group (Control Group). The primary outcome was the duration of the first anal exhaust and defecation after surgery. And the visual analogue scale (VAS) score of abdominal distension, shoulder pain, nausea, and adverse events within 72 h after surgery were observed.

Results: Cases of the three groups were 79, 71, and 76. The anal exhaust time was 40.59 ± 18.21, 54.54 ± 12.88, and 62.26 ± 15.79 h, while the first defecation time was 56.28 ± 12.21, 71.13 ± 11.29, and 78.36 ± 14.71 h respectively. The operation duration affected the anal exhaust time (P < 0.05). Acupuncture timing affected recovery time statistically (P < 0.05). The VAS for abdominal distension, shoulder pain and nausea in Observation Group 1 (3.86 ± 2.2, 1.45 ± 1.21, and 2.45 ± 2.18) were lower than the other two groups (4.31 ± 1.58, 3.57 ± 2.00, and 3.70 ± 1.99; 4.59 ± 2.65, 4.51 ± 2.38, and 4.34 ± 2.32; P < 0.05). The VAS for shoulder pain in Observation Group 2 was lower than the Control Group (P < 0.05). Observation Group 1 showed a higher clinical recovery rate (72.15%) compared to the other two groups (43.66% and 31.58%, P < 0.05). The efficacy rate of the Observation Groups (87.34% and 88.73%) was considerably higher than the Control Group (69.74%, P < 0.05), while the difference between the two Observation Groups was insignificant (P > 0.05).

Conclusions: The operation duration is the main factor that influences gastrointestinal dysfunction after surgery. Acupuncture can improve gastrointestinal function. It is advisable to initiate acupuncture as early as possible.

Trial registration: N/A.