Neuropsychiatric Disease and Treatment (Apr 2023)
Transcutaneous Electrical Acupoint Stimulation for Preventing Postoperative Delirium: A Meta-Analysis
Abstract
Fei Guo,1,* Yuting Yan,1,* Li Sun,1 Ruili Han,1 Lanlan Zheng,1 Yuan Qin,1 Shuang Wang,1 Xude Sun,1 Zhaohua Ji,2 Changjun Gao1 1Department of Anesthesiology, Second Affiliated Hospital of Air Force Medical University, Xi’an, 710038, People’s Republic of China; 2Department of Epidemiology, School of Public Health, Ministry of Education Key Laboratory of Hazard Assessment and Control in Special Operational Environment, Air Force Medical University, Xi’an, 710032, People’s Republic of China*These authors contributed equally to this workCorrespondence: Changjun Gao, Department of Anesthesiology, Second Affiliated Hospital of Air Force Medical University, Xin Si Road & 569, Xi’an City, Shaanxi, 710038, People’s Republic of China, Tel/Fax +86 2984777439, Email [email protected] Zhaohua Ji, Department of Epidemiology, School of Public Health, Ministry of Education Key Laboratory of Hazard Assessment and Control in Special Operational Environment, Air Force Medical University, ChangLe Road & 169, Xi’an City, Shaanxi, 710032, People’s Republic of China, Tel/Fax +86 2884711316, Email [email protected]: This meta-analysis of randomized controlled trials (RCTs) aims to evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) for postoperative delirium (POD) in surgical patients.Methods: Based on database searches of the Wanfang, China National Knowledge Infrastructure (CNKI), VIP, Chinese Biology Medicine (CBM), PubMed, Cochrane Library, and Web of Science, relevant RCTs published before December 30, 2022, were extracted. Outcome indicators included the incidence of POD, changes in Confusion Assessment Method (CAM) scores, Visual Analogue Scale (VAS) scores, and the intraoperative consumption of anesthetics. Data were pooled and analyzed by Review Manager 5.3, and publication bias detection was conducted using Stata 17.0.Results: A meta-analysis containing 715 experimental and 717 control participants from 12 RCTs was performed. The overall results showed that TEAS had obvious superiority with a lower incidence of POD on any day during the postoperative 1 week. In subgroup analyses, the CAM scores on the third postoperative day were significantly lower in the TEAS group than in the control group (MD = − 0.52, 95% CI: − 1.02 to − 0.03, P = 0.04), the VAS scores on the first postoperative day were significantly lower in the TEAS group than in the control group (MD = − 0.19, 95% CI: − 0.36 to − 0.02, P = 0.03), the consumption of propofol and remifentanil were both significantly lower in the TEAS group compared with the control group (MD = − 23.1, 95% CI: − 37.27 to − 8.94, P = 0.001; MD = − 105.69, 95% CI: − 174.20 to − 37.19, P = 0.002). No serious adverse events of TEAS were reported in any of the referenced studies.Conclusion: TEAS has an obvious curative effect in preventing POD and pain in the earlier stage of surgical patients. It could be a promising assisted anesthesia technique in the future.Keywords: transcutaneous electrical acupoint stimulation, TEAS, postoperative delirium, POD, meta-analysis
