背景:接受电视胸腔镜肺叶切除术(VATL)的患者通常会经历慢性术后疼痛(CPSP)。术后疼痛可影响术后肺功能恢复,延长术后恢复时间,增加患者住院费用。经皮穴位电刺激(TEAS)是一种基于针灸的替代疗法,已在各个医学领域的术后恢复和疼痛管理中显示出希望。然而,目前缺乏专门针对VATL后CPSP改善的研究。本研究的目的是评估TEAS是否可以有效降低VATL患者术后慢性疼痛的严重程度和发生。通过调查TEAS在VATL后缓解CPSP的潜在好处,本研究旨在为支持将TEAS纳入VATL患者的术后护理方案提供有价值的临床证据.
方法:本研究是前瞻性的,单中心,双盲,随机对照试验将在联合后勤保障部队第920医院进行。将80例接受VATL的患者随机分为实验组(TEAS组)和对照组(假手术组)。实验组将在双侧PC6,LI4,LR3,LU5,TE5和LI11接受TEAS。对照组在相同的穴位不接受TEAS。两组均在麻醉诱导前及术后1-7天接受TEAS或不接受TEAS,每个会话持续30分钟。
■主要结果是手术后3个月的CPSP发生率。次要结果将包括术后6个月的CPSP发生率,手术后3个月和6个月的数字评定量表(NRS)评分,以及手术后24、48和72小时的NRS评分,全身麻醉期间的瑞芬太尼消耗,对抢救镇痛药的需求,留置胸管的数量和持续时间,术后恶心和呕吐的发生率,去甲肾上腺素(NE)的变化,皮质醇(Cor),肿瘤坏死因子(TNF-α),和血清中的白细胞介素6(IL-6)。
背景:ChiCTR2300069458。2023年3月16日注册。
BACKGROUND: Patients undergoing video-assisted thoracoscopic lobectomy (VATL) often experience chronic postsurgical pain (CPSP). Postoperative pain can affect the recovery of postoperative lung function, prolong postoperative recovery time, and increase patient hospitalization expenses. Transcutaneous electrical acupoint stimulation (TEAS) is an alternative therapy based on acupuncture that has shown promise in postoperative recovery and pain management across various medical fields. However, research specifically focused on the improvement of CPSP after VATL is currently lacking. The purpose of this study is to evaluate whether TEAS can effectively reduce the severity and occurrence of chronic postsurgical pain in patients undergoing VATL. By investigating the potential benefits of TEAS in mitigating CPSP after VATL, this study aims to provide valuable clinical evidence to support the integration of TEAS into postoperative care protocols for patients undergoing VATL.
METHODS: This study is a prospective, single-center, double-blinded, randomized controlled trial to be conducted at the 920th Hospital of Joint Logistics Support Force. Eighty patients undergoing VATL will be randomly divided into an experimental group (TEAS group) and a control group (sham group). The experimental group will receive TEAS at bilateral PC6, LI4, LR3, LU5, TE5, and LI11. The control group will not receive TEAS at the same acupoints. Both groups will receive TEAS or no TEAS before anesthesia induction and 1-7 days after surgery, with each session lasting 30 min.
UNASSIGNED: The primary outcome will be the incidence of CPSP at 3 months after surgery. Secondary outcomes will include the incidence of CPSP at 6 months after surgery, the numerical rating scale (NRS) scores at 3 and 6 months after surgery, as well as the NRS scores at 24, 48, and 72 h after surgery, remifentanil consumption during general anesthesia, demand for rescue analgesics, number and duration of indwelling chest tubes, incidence of postoperative nausea and vomiting, and changes of norepinephrine (NE), cortisol (Cor), tumor necrosis factor (TNF- α), and interleukin 6 (IL-6) in serum.
BACKGROUND: ChiCTR2300069458. Registered on March 16, 2023.