[Effects of transcutaneous electrical acupoint stimulation at Neiguan (PC6) and Jianshi (PC5) on autonomic nervous function and inflammatory factors in frail elderly patients after surgery].

Objectives: To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) at the bilateral acupoints Neiguan (PC6) and Jianshi (PC5) on heart rate variability (HRV) and inflammatory factors in frail elderly patients undergoing laparoscopic colorectal cancer surgery under general anesthesia.

Methods: A total of 78 frail elderly patients undergoing elective laparoscopic colorectal cancer surgery were randomized into the TEAS group (39 patients, with 2 patients dropping out) and the control group (39 patients, with 1 patient dropping out). In the TEAS group, TEAS was applied to the bilateral PC6 and PC5 from 30 min before anesthesia induction until the end of the surgery. The control group was connected to an electronic acupuncture instrument at the same acupoints but did not receive electrical stimulation. A short-term Holter electrocardiogram was used to collect HRV parameters in the frequency domain, including low-frequency power (LF), high-frequency power (HF), and the LF/HF ratio. Serum concentrations of C-reactive protein (CRP) and interleukin-6 (IL-6) were measured using ELISA. The Quality of Recovery-15 (Qor-15) score was recorded, along with adverse reactions such as postoperative nausea and vomiting (PONV), palpitations, chest tightness, and chest pain.

Results: Compared with 1 d before surgery, LF and HF were significantly decreased (P<0.05), and the LF/HF ratio significantly increased (P<0.05) at 1, 2, and 3 d after surgery in the control group. In the TEAS group, both LF and the LF/HF ratio were significantly decreased (P<0.05) at 1, 2, and 3 d after surgery. Compared with the control group, LF and HF levels were significantly increased (P<0.05), and the LF/HF ratio was significantly decreased (P<0.05) in the TEAS group at 1, 2, and 3 d after surgery. Both groups exhibited increased levels of CRP and IL-6 at 1, 3, and 5 d after surgery compared to 1 d before surgery (P<0.05), with the TEAS group showing lower CRP and IL-6 levels than the control group (P<0.05). Compared to baseline before surgery, the Qor-15 scores of both groups were decreased at 1, 2, and 3 d after surgery (P<0.05), with the TEAS group showing significantly higher Qor-15 scores than those in the control group (P<0.05). The incidence of PONV, palpitations, chest tightness, and chest pain in the TEAS group was lower than that in the control group (P<0.05).

Conclusions: TEAS at the PC6 and PC5 can regulate autonomic nervous function, reduce the early postoperative sympathetic nerve excitation, maintain parasympathetic nerve tension, reduce inflammatory responses, improve the quality of postoperative recovery, and decrease the incidence of postoperative adverse reactions in frail elderly patients after laparoscopic colorectal cancer surgery.