Effects of Transcutaneous Electrical Acupoint Stimulation on Postoperative Recovery in Patients Undergoing Endoscopic Submucosal Dissection: A Prospective, Randomized Clinical Trial

Abstract Background: Postoperative abdominal pain is one of the most common minor adverse events of endoscopic submucosal dissection (ESD) surgery which is a well-established treatment for early gastrointestinal neoplasms. Transcutaneous electrical acupoint stimulation (TEAS) is a potential treatment option for reducing postoperative pain and improving gastrointestinal function. This study aims to assess the efficacy of TEAS for postoperative pain and gastrointestinal function recovery in patients after ESD surgery for early gastric and esophageal neoplasms. Methods: A total of 129 patients undergoing ESD surgery were randomized into the TEAS group or the sham group and were stratified by the surgical type (i.e., gastric or esophageal ESD surgery). Patients in the TEAS group were treated bilaterally at the Acupoint Hegu (L14), Neiguan (PC6), Zusanli (ST36), and Shangjuxu (ST37). Patients in the sham group were treated at sham acupoints. The TEAS and sham stimulations are both given from 30 min before surgery to the end of the surgery. Postoperative pain was measured by a visual analog scale. T-tests, Mann-Whitney U test, chi-square test, Fisher's test, and univariate and multivariate logistic regression analysis were used to analyze the data of this study. Results: Compared with the sham group, the pain levels of the TEAS group improved from 5 min after surgery to 1 hour after surgery (P＜0.05). The incidence of moderate to severe pain, postoperative nausea and vomiting, and cases needing morphine were significantly lower in the TEAS group (P＜0.05). There was no statistically significant difference between the two groups in the postoperative recovery of gastrointestinal function. Conclusion:Pretreating with TEAS could effectively improve the early postoperative pain of patients, reduce the incidence of moderate to severe pain, decrease the application of morphine after surgery, and reduce the occurrence of postoperative nausea and vomiting. Trial registration: Chinese Clinical Trial Registry, ChiCTR2100052837. (06/11/2021)