Does transcutaneous electric acupoint stimulation improve the quality of recovery after thyroidectomy? A prospective randomized controlled trial.

BACKGROUND We evaluated the effects of transcutaneous electric acupoint stimulation (TEAS) on the postoperative quality of recovery after thyroidectomy with general anesthesia in this prospective, randomized, double-blind, placebo-controlled study. METHODS Eight-four American Society of Anesthesiologists physical status (ASA) I or II patients undergoing thyroidectomy were randomly allocated to TEAS or control groups. The primary outcome was the quality of recovery, which was assessed on the day before surgery and 24 h after surgery using the Quality of Recovery 40 questionnaire (QoR-40). Secondary outcomes included the incidence of postoperative nausea and vomiting (PONV), postoperative pain intensity, duration of post anesthesia care unit (PACU) stay and patient's satisfaction. RESULTS Global QoR-40 score at 24 h after surgery was higher in the TEAS group (median [interquartile range], 183 [172-190]) compared with the control group (168 [154-183]) (P < 0.001). Compared with the control group, postoperative pain intensity and the cumulative number of opioids administered was lower in the TEAS group patients (P < 0.001). TEAS reduced the incidence of PONV and dizziness (P = 0.001), as well as the duration of PACU stay (P < 0.001). Simultaneously, the patient's satisfaction scores were higher in the TEAS group (P = 0.002). CONCLUSION Preoperative TEAS enhances the quality of recovery, postoperative analgesia and patient's satisfaction, alleviates postoperative side effects and accelerates discharge after general anesthesia for thyroidectomy.

[1]  Hang-Seok Chang,et al.  The effect of intra‐operative transcutaneous electrical nerve stimulation on posterior neck pain following thyroidectomy , 2015, Anaesthesia.

[2]  Won Sang Lee,et al.  Comparison of Ramosetron Plus Dexamethasone with Ramosetron Alone on Postoperative Nausea, Vomiting, Shivering and Pain after Thyroid Surgery , 2015, The Korean journal of pain.

[3]  L. Xiong,et al.  The effect of pre‐treatment with transcutaneous electrical acupoint stimulation on the quality of recovery after ambulatory breast surgery: a prospective, randomised controlled trial , 2014, Anaesthesia.

[4]  N. Xu,et al.  Transcutaneous electric acupoint stimulation reduces intra-operative remifentanil consumption and alleviates postoperative side-effects in patients undergoing sinusotomy: a prospective, randomized, placebo-controlled trial. , 2014, British journal of anaesthesia.

[5]  S. Bergese,et al.  Consensus Guidelines for the Management of Postoperative Nausea and Vomiting , 2014, Anesthesia and analgesia.

[6]  Ming Xu,et al.  The Effects of P6 Electrical Acustimulation on Postoperative Nausea and Vomiting in Patients After Infratentorial Craniotomy , 2012, Journal of neurosurgical anesthesiology.

[7]  A. Castagnoli,et al.  [A single effective way to reduce post-thyroidectomy discomfort: a clinical trial]. , 2011, Minerva Chirurgica.

[8]  D. Terris,et al.  Outpatient thyroidectomy: Experience in over 200 patients , 2010, The Laryngoscope.

[9]  T. Gin,et al.  Psychometric Testing of the Chinese Quality of Recovery Score , 2008, Anesthesia and analgesia.

[10]  P. Myles,et al.  Measurement of Quality of Recovery in 5672 Patients after Anaesthesia and Surgery , 2000, Anaesthesia and intensive care.

[11]  Jisheng Han,et al.  Electroacupuncture: mechanisms and clinical application , 1998, Biological Psychiatry.

[12]  J. Sonner,et al.  Nausea and vomiting following thyroid and parathyroid surgery. , 1997, Journal of clinical anesthesia.

[13]  L. Terenius,et al.  Effect of low- and high-frequency TENS on Met-enkephalin-Arg-Phe and dynorphin A immunoreactivity in human lumbar CSF , 1991, Pain.

[14]  J. Dundee,et al.  Local anesthesia blocks the antiemetic action of P6 acupuncture , 1991, Clinical pharmacology and therapeutics.

[15]  Jun Woo Jung,et al.  A prospective, randomized, controlled trial of the postoperative analgesic effects of spraying 0.25 % levobupivacaine after bilateral axillo-breast approach robotic thyroidectomy , 2014, Surgical Endoscopy.

[16]  Y. Fujii Retraction Notice: The Benefits and Risks of Different Therapies in Preventing Postoperative Nausea and Vomiting in Patients Undergoing Thyroid Surgery , 2008, Current drug safety.

[17]  C. Yuan,et al.  Analgesic effects of different acupoint stimulation frequencies in humans. , 2003, The American journal of Chinese medicine.

[18]  J. Shen,et al.  Research on the neurophysiological mechanisms of acupuncture: review of selected studies and methodological issues. , 2001, Journal of alternative and complementary medicine.

[19]  P. Myles,et al.  Validity and reliability of a postoperative quality of recovery score: the QoR-40. , 2000, British journal of anaesthesia.

[20]  J. Wordliczek,et al.  [Postoperative pain treatment]. , 2000, Przeglad lekarski.