Effect of Transcutaneous Electrical Acupoint Stimulation on Postoperative Sleep Disorders in Older Patients After Urologic Laparoscopic Surgery by Regulating Intestinal Microbiota: Study Protocol for a Prospective Controlled Trial.

Postoperative sleep disorders (PSD) are common complications that may impair recovery and increase the risk of adverse events after surgery. Transcutaneous electrical acupoint stimulation (TEAS), a non-invasive therapy based on traditional Chinese medicine, has shown potential in improving sleep quality. This study aims to investigate whether TEAS can alleviate PSD in older patients undergoing urologic laparoscopic surgery. This is a prospective, randomized, double-blind, controlled clinical trial. A total of 124 patients scheduled for urologic laparoscopic surgery will be randomly assigned to either the TEAS group (receiving active stimulation) or the sham group (receiving placebo stimulation). Randomization will also be stratified according to the use of dexmedetomidine. The primary outcome is the Athens Insomnia Scale (AIS) score on the postoperative night (D2), compared between groups using ANCOVA adjusted for preoperative (baseline) AIS and the dexmedetomidine stratification factor. Secondary outcomes include the night-to-night trajectory of AIS across D0-D2, objective sleep parameters measured by a portable monitor on D0-D2, postoperative VAS pain scores, perioperative changes in intestinal microbiota and serum brain-gut peptides, intraoperative hemodynamics and drug consumption, durations of surgery/anesthesia/extubation, postoperative complications, and healthcare-related costs. This trial aims to explore whether TEAS can improve postoperative sleep quality in older patients by regulating intestinal microbiota. The findings are expected to provide evidence supporting the clinical application of TEAS for managing PSD in this patient population. ChiCTR2400086911 (Registered on 15 July 2024) https://www.chictr.org.cn/showproj.html?proj=220900.