Effect of transcutaneous auricular vagus nerve stimulation on postoperative recovery of gastrointestinal function in patients with gynecological laparoscopic surgery

doi:10.11958/20242049

Abstract

Abstract:

Objective To explore the effect of transcutaneous auricular vagus nerve stimulation (taVNS) on postoperative recovery of gastrointestinal function in gynecological laparoscopic surgery patients. Methods Ninety-six patients who underwent elective laparoscopic total hysterectomy were selected. According to the random number table method, patients were divided into the taVNS group (group T) and the sham stimulation group (group F) with 48 patients in each group. The conventional general anesthesia method was used in both groups. The group T received taVNS once before surgery and once in the anaesthesia recovery room with 30 min per stimulation, while the group F was given sham stimulation for 30 min each. Postoperative recovery time of anal gas and defecation, the I-FEED scores on the 1st, 2nd and 3rd postoperative days, the GSRS score on the 3rd postoperative day were recorded. The NRS scores on the 1st and 2nd postoperative days, postoperative remedial analgesia, occurrence of postoperative adverse effects and duration of postoperative hospitalization were recorded. Results Compared with the group F, the time to first postoperative anal exhaust and defecation was significantly shorter in the group T. The I-FEED scores on the 1st, 2nd and 3rd postoperative days, and the GSRS score on 3rd postoperative day were significantly decreased in the group T. The proportion of patients with postoperative gastrointestinal intolerance and postoperative gastrointestinal dysfunction were reduced in the group T (P<0.05). NRS scores at postoperative days 1, and 2 were decreased and the incidence of postoperative nausea was lower (P<0.05). There were no significant differences in postoperative remedial analgesia, the occurrence of postoperative vomiting, dizziness, bradycardia and hypotension, and duration of postoperative hospitalization in the two groups of patients (P>0.05). Conclusion taVNS can improve the recovery of postoperative gastrointestinal function, reduce postoperative nausea and alleviate postoperative pain in laparoscopic total hysterectomy patients.

Key words: transcutaneous electric nerve stimulation, vagus nerve stimulation, laparoscopy, gynecological surgery, postoperative gastrointestinal function

CLC Number:

R614

Figures/Tables 6

References 23

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组别			年龄/岁		身高/cm				体质量/kg		高血压
F组			51.2±6.2		160.0（155.3，163.0）				64.0（60.0，69.4）		15（31.3）
T组			50.0±5.5		159.0（156.0，160.0）				65.0（60.0，70.0）		18（37.5）
t、Z或χ²			1.034		0.584				0.750		0.416
组别		糖尿病		腹部手术史			手术时间/min			舒芬太尼/μg
F组		5（10.4）		20（41.7）			100.0（91.0，122.0）			40.0（35.0，43.8）
T组		4（8.3）		20（41.7）			96.0（78.3，112.3）			40.0（35.0，45.0）
χ²或Z		0.000		0.000			1.144			1.476
组别	丙泊酚/mg					瑞芬太尼/mg		原发病（肌瘤/腺肌症/其他）
F组	468.0（374.5，575.3）					0.6（0.5，0.7）		21/14/13
T组	434.0（342.8，554.0）					0.6（0.4，0.7）		22/16/10
Z或χ²	0.769					0.663		0.548

组别			年龄/岁		身高/cm				体质量/kg		高血压
F组			51.2±6.2		160.0（155.3，163.0）				64.0（60.0，69.4）		15（31.3）
T组			50.0±5.5		159.0（156.0，160.0）				65.0（60.0，70.0）		18（37.5）
t、Z或χ²			1.034		0.584				0.750		0.416
组别		糖尿病		腹部手术史			手术时间/min			舒芬太尼/μg
F组		5（10.4）		20（41.7）			100.0（91.0，122.0）			40.0（35.0，43.8）
T组		4（8.3）		20（41.7）			96.0（78.3，112.3）			40.0（35.0，45.0）
χ²或Z		0.000		0.000			1.144			1.476
组别	丙泊酚/mg					瑞芬太尼/mg		原发病（肌瘤/腺肌症/其他）
F组	468.0（374.5，575.3）					0.6（0.5，0.7）		21/14/13
T组	434.0（342.8，554.0）					0.6（0.4，0.7）		22/16/10
Z或χ²	0.769					0.663		0.548

组别	首次排气时间/h	首次排便时间/h
F组	28.8（22.5，38.9）	68.6±21.9
T组	24.8（18.0，28.6）	54.8±18.5
Z或t	2.777^＊＊	3.333^＊＊

组别	首次排气时间/h	首次排便时间/h
F组	28.8（22.5，38.9）	68.6±21.9
T组	24.8（18.0，28.6）	54.8±18.5
Z或t	2.777^＊＊	3.333^＊＊

组别	I-FEED评分/分			术后3 d GSRS 评分/分
组别	术后第1天	术后第2天	术后第3天	术后3 d GSRS 评分/分
F组	2（0，4）	0（0，2）	0（0，0）	28.0±3.9
T组	0（0，2）	0（0，0）	0（0，0）	23.2±3.1
Z或t	2.791^＊＊	2.914^＊＊	2.668^＊＊	6.642^＊＊