Preventive Effect of Transcutaneous Electrical Acupoint Stimulation Combined with Auricular Acupressure on Delirium After Abdominal Surgery in Elderly Patients

ZHANG Jing; LIU Ya'nan; YE Yujun

doi:10.16295/j.cnki.0257-358x.2025.09.012

Abstract：Objective:To explore the effect of con-ventional Western medical interventions during the perioperative period combined with transcutaneous electrical acupoint stimulation(TEAS)and auricular acupressure on the prevention of delirium after abdominal surgery in elderly patients.Methods:A total of 132 elderly patients who were scheduled to undergo abdominal surgery were selected.They were divided into control group,Intervention Group 1,and Intervention Group 2 using a random drawing method,with 44 patients in each group.The control group received conventional Western medical interventions.Intervention Group 1 received TEAS based on the treatment of the control group.Intervention Group 2 received both TEAS and auricular acupressure based on the treatment of the control group.The indicators related to anesthesia and surgery,the incidence of delirium within 5 days after surgery,the Delirium Rating Scale(DRS)score,the Visual Analogue Scale(VAS)score,the Pittsburge Sleep Quility Index(PSQI)score,sleep structure,serological indicators[melatonin(MT),glial fibrillary acidic protein(GFAP),neutrophil gelatinase-associated lipocalin(NGAL)],and incidence of complications during hospitalization were compared among the three groups.Results:There were no statistically significant differences in the anesthesia time,intraoperative blood loss,and operation time among the three groups(P＞0.05).The intra-operative opioid consumption in Intervention Group 2 and Intervention Group 1 was lower than that in the control group(P＜0.05).The hospital stay in Intervention Group 2 and Intervention Group 1 was shorter than that in the control group,and the hospital stay in Intervention Group 2 was shorter than that in Intervention Group 1(P＜0.05).The incidence of delirium on the 5th day after surgery in Intervention Group 2 was lower than that in the control group(P＜0.05).The DRS scores of Intervention Group 2 and Intervention Group 1 were lower than that of the control group(P＜0.05),and the DRS score of Intervention Group 2 was lower than that of Intervention Group 1(P＜0.05).There were interaction effects between groups and time points for the VAS score across the three groups(Fbetween groups=125.068,Ftime points=82.069,Finteraction=106.253,all P＜0.05).From 1 to 5 days after surgery,the VAS scores of Intervention Group 2 and Intervention Group 1 were lower than that of the control group(P＜0.05),and the VAS score of Intervention Group 2 was lower than that of Intervention Group 1(P＜0.05).On the 5th day after surgery,in all the three groups,the PSQI scores were lower than those before surgery(P＜0.05),the sleep onset time was shorter than that before surgery(P＜0.05),and the sleep duration and deep sleep duration were both longer than those before surgery(P＜0.05).On the 5th day after surgery,the PSQI scores of Intervention Group 2 and Intervention Group 1 were lower than that of the control group(P＜0.05),the sleep onset time of Intervention Group 2 and Intervention Group 1 was shorter than that of the control group(P＜0.05),the sleep duration and deep sleep duration of Intervention Group 2 and Intervention Group 1 were longer than those of the control group(P＜0.05),and the levels of the above sleep indicators of Intervention Group 2 were better than those of Intervention Group 1(P＜0.05).On the 5th day after surgery,the levels of GFAP and NGAL in all three groups were higher than those before surgery(P＜0.05),while the level of MT was lower than that before surgery(P＜0.05).On the 5th day after surgery,the levels of GFAP and NGAL in both Intervention Group 2 and Intervention Group 1 were lower than those in the control group(P＜0.05),and the level of MT was higher than that in the control group(P＜0.05).Moreover,the levels of above serological indicators in Intervention Group 2 were better than those in Intervention Group 1(P＜0.05).There was no statistically significant difference in the incidence of complications during hospitalization among the three groups(P＞0.05).Conclusions:During the perioperative period,the combination of conventional Western medical interventions,TEAS,and auricular acupressure can effectively improve the sleep quality and structure of elderly patients undergoing abdominal surgery,relieve postoperative pain,regulate the expression levels of GFAP,MT,and NGAL,reduce the incidence of postoperative delirium,and demonstrate relatively high safety.