Effect of buccal acupuncture therapy on the incidence of postoperative delirium in older adults undergoing orthopedic lower limb surgery: A randomized controlled trial

Objective

This study evaluated the effect of perioperative buccal acupuncture therapy on the incidence of postoperative delirium in elderly patients who underwent orthopedic lower limb surgery.

Methods

This was a single-center, prospective, randomized controlled trial. A total of 120 elderly patients (aged ≥65 years) scheduled for elective orthopedic lower limb surgery were randomly assigned to the intervention group (n = 60, buccal acupuncture 30 min before anesthesia induction until the end of surgery and for 30 min each day for the first 2 postoperative days) or the control group (n = 60, no buccal acupuncture). The primary outcome was delirium during the first 7 postoperative days. The secondary outcomes included delirium severity, duration, and subtype; intraoperative total consumption rate of sufentanil and remifentanil; interleukin-6, interleukin-8, and norepinephrine in venous blood; the total number of electronic analgesia pump compressions; nausea and vomiting in 48 h; postoperative pain score; postoperative hospital stay, and postoperative adverse event rates.

Results

The data of 120 patients were collected. The incidence of delirium during the first 7 postoperative days was significantly lower in the intervention group than in the control group (27 % [16/60] vs. 12 % [7/60]; relative risk, 0.44; 95 % confidence interval, 0.19–0.99; P = 0.037). Intraoperative total consumption rate of sufentanil and remifentanil, postoperative pain scores, and the incidence of postoperative nausea and vomiting were significantly lower in the intervention group.

Conclusion

Buccal acupuncture can reduce the incidence of postoperative delirium in elderly patients who undergo orthopedic lower limb surgery.