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Review
. 2023 Apr 15:19:907-920.
doi: 10.2147/NDT.S404805. eCollection 2023.

Transcutaneous Electrical Acupoint Stimulation for Preventing Postoperative Delirium: A Meta-Analysis

Fei Guo #  1 , Yuting Yan #  1 , Li Sun  1 , Ruili Han  1 , Lanlan Zheng  1 , Yuan Qin  1 , Shuang Wang  1 , Xude Sun  1 , Zhaohua Ji  2 , Changjun Gao  1
Affiliations
Review

Transcutaneous Electrical Acupoint Stimulation for Preventing Postoperative Delirium: A Meta-Analysis

Fei Guo et al. Neuropsychiatr Dis Treat. .

Abstract

Objective: This meta-analysis of randomized controlled trials (RCTs) aims to evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) for postoperative delirium (POD) in surgical patients.

Methods: Based on database searches of the Wanfang, China National Knowledge Infrastructure (CNKI), VIP, Chinese Biology Medicine (CBM), PubMed, Cochrane Library, and Web of Science, relevant RCTs published before December 30, 2022, were extracted. Outcome indicators included the incidence of POD, changes in Confusion Assessment Method (CAM) scores, Visual Analogue Scale (VAS) scores, and the intraoperative consumption of anesthetics. Data were pooled and analyzed by Review Manager 5.3, and publication bias detection was conducted using Stata 17.0.

Results: A meta-analysis containing 715 experimental and 717 control participants from 12 RCTs was performed. The overall results showed that TEAS had obvious superiority with a lower incidence of POD on any day during the postoperative 1 week. In subgroup analyses, the CAM scores on the third postoperative day were significantly lower in the TEAS group than in the control group (MD = -0.52, 95% CI: -1.02 to -0.03, P = 0.04), the VAS scores on the first postoperative day were significantly lower in the TEAS group than in the control group (MD = -0.19, 95% CI: -0.36 to -0.02, P = 0.03), the consumption of propofol and remifentanil were both significantly lower in the TEAS group compared with the control group (MD = -23.1, 95% CI: -37.27 to -8.94, P = 0.001; MD = -105.69, 95% CI: -174.20 to -37.19, P = 0.002). No serious adverse events of TEAS were reported in any of the referenced studies.

Conclusion: TEAS has an obvious curative effect in preventing POD and pain in the earlier stage of surgical patients. It could be a promising assisted anesthesia technique in the future.

Keywords: POD; TEAS; meta-analysis; postoperative delirium; transcutaneous electrical acupoint stimulation.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Flow diagram of the trials screening procedures.
Figure 2
Figure 2
Cochrane risk of bias assessment.
Figure 3
Figure 3
Forest plot of the incidence of POD in both groups on different days.
Figure 4
Figure 4
Forest plot of the incidence of POD in both groups within different days.
Figure 5
Figure 5
Forest plot of CAM scores in both groups.
Figure 6
Figure 6
Forest plot of VAS scores in both groups.
Figure 7
Figure 7
Forest plot of intraoperative consumption of anesthetics in both groups.
Figure 8
Figure 8
Forest plot of serum levels of IL-6 on the postoperative first day.
Figure 9
Figure 9
Funnel plot of the incidence of POD within postoperative 3 days.
See this image and copyright information in PMC

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