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Published in: BMC Complementary Medicine and Therapies 1/2023

Open Access 01-12-2023 | Acupuncture | Study Protocol

Effects of transcutaneous electrical acupoint stimulation (TEAS) on postoperative pain in patients undergoing gastric and esophageal ESD surgery: a study protocol for a prospective randomized controlled trial

Authors: Xin-Lu Chang, Xu-Ming Liu, Li-Xin An, Jian-Yong Zheng, Ke Zhang

Published in: BMC Complementary Medicine and Therapies | Issue 1/2023

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Abstract

Background

Post-operative pain of endoscopic submucosal dissection (ESD) is always be overlooked and undertreated by endoscopists. However, the incidence of moderate to severe pain after ESD is as high as 44.9% to 62.8%, which can greatly affect the patient’s recovery, reduce their satisfaction, and extend their hospital stay. Transcutaneous electrical acupoint stimulation (TEAS) have been shown to reduce postoperative pain and enhance gastrointestinal (GI) function recovery in patients undergoing abdomen surgery. However, there is no evidence regarding on the effect of TEAS on post-operative pain and complications in patients undergoing ESD. Therefore, we aim to investigate whether perioperative TEAS treatment is superior to the sham acupuncture in terms of post-ESD pain and GI function recovery.

Methods

This study is a prospective, randomized controlled trail, which is single-blinded and in single center. A total of 120 patients undergoing elective gastric and esophageal ESD surgery in Beijing Friendship Hospital, Capital Medical University, will be involved in this study. These individuals will be stratified according to the type of ESD surgery (i.e. gastric or esophageal procedure) and be randomly divided into two groups. L14, PC6, ST36 and ST37 will be stimulated at the TEAS treatment group, and the control group will receive simulation at four sham acupoints. The primary outcome is post-EDS VAS score at the time of entering PACU, 10 min, 20 min, 30 min, 1 h, 2 h, 4 h, 6 h, 18 h, 24 h, 48 h after the surgery. The secondary outcomes include the anesthesia-associated parameters, sedation score, nausea and vomiting score, shivering score, recovery of gastrointestinal function, satisfaction of patients to anesthesia, incidence of postoperative complications, QLQ-C30 life quality scale, and the economic indicators.

Discussion

The results of this study will confirm that continuous preventive application of TEAS can alleviate the postoperative pain among patients with gastric and esophageal ESD surgery and accelerate the recovery of post-ESD gastrointestinal function.

Trial registration

Chinese Clinical Trial Registry, ID: ChiCTR2100052837, registered on November 6, 2021. http://​www.​chictr.​org.​cn/​showproj.​aspx?​proj=​135892.
Appendix
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Literature
1.
go back to reference ASGE Technology Committee, Maple JT, Abu Dayyeh BK, Chauhan SS, Hwang JH, Komanduri S, et al. Endoscopic submucosal dissection. Gastrointest Endosc. 2015;81(6):1311–25.CrossRef ASGE Technology Committee, Maple JT, Abu Dayyeh BK, Chauhan SS, Hwang JH, Komanduri S, et al. Endoscopic submucosal dissection. Gastrointest Endosc. 2015;81(6):1311–25.CrossRef
2.
go back to reference Jeon WJ, You IY, Chae HB, Park SM, Youn SJ. A new technique for gastric endoscopic submucosal dissection: peroral traction-assisted endoscopic submucosal dissection. Gastrointest Endosc. 2009;69(1):29–33.CrossRefPubMed Jeon WJ, You IY, Chae HB, Park SM, Youn SJ. A new technique for gastric endoscopic submucosal dissection: peroral traction-assisted endoscopic submucosal dissection. Gastrointest Endosc. 2009;69(1):29–33.CrossRefPubMed
3.
go back to reference Kim JH, Nam HS, Choi CW, Kang DH, Kim HW, Park SB, et al. Risk factors associated with difficult gastric endoscopic submucosal dissection: predicting difficult ESD. Surg Endosc. 2017;31(4):1617–26.CrossRefPubMed Kim JH, Nam HS, Choi CW, Kang DH, Kim HW, Park SB, et al. Risk factors associated with difficult gastric endoscopic submucosal dissection: predicting difficult ESD. Surg Endosc. 2017;31(4):1617–26.CrossRefPubMed
4.
go back to reference Kim JW, Jang JY, Park YM, Shim JJ, Chang YW. Clinicopathological characteristics of patients with pain after endoscopic submucosal dissection for gastric epithelial neoplasm. Surg Endosc. 2019;33(3):794–801.CrossRefPubMed Kim JW, Jang JY, Park YM, Shim JJ, Chang YW. Clinicopathological characteristics of patients with pain after endoscopic submucosal dissection for gastric epithelial neoplasm. Surg Endosc. 2019;33(3):794–801.CrossRefPubMed
6.
go back to reference Delaney CP, Zutshi M, Senagore AJ, Remzi FH, Hammel J, Fazio VW. Prospective, randomized, controlled trial between a pathway of controlled rehabilitation with early ambulation and diet and traditional postoperative care after laparotomy and intestinal resection. Dis Colon Rectum. 2003;46(7):851–9.CrossRefPubMed Delaney CP, Zutshi M, Senagore AJ, Remzi FH, Hammel J, Fazio VW. Prospective, randomized, controlled trial between a pathway of controlled rehabilitation with early ambulation and diet and traditional postoperative care after laparotomy and intestinal resection. Dis Colon Rectum. 2003;46(7):851–9.CrossRefPubMed
7.
go back to reference Pyo JH, Lee H, Min YW, Min BH, Lee JH, Rhee PL, et al. A Comparative randomized trial on the optimal timing of dexamethasone for pain relief after endoscopic submucosal dissection for early gastric neoplasm. Gut Liver. 2016;10(4):549–55.CrossRefPubMedPubMedCentral Pyo JH, Lee H, Min YW, Min BH, Lee JH, Rhee PL, et al. A Comparative randomized trial on the optimal timing of dexamethasone for pain relief after endoscopic submucosal dissection for early gastric neoplasm. Gut Liver. 2016;10(4):549–55.CrossRefPubMedPubMedCentral
8.
go back to reference Kim B, Lee H, Chung H, Park JC, Shin SK, Lee SK, et al. The efficacy of topical bupivacaine and triamcinolone acetonide injection in the relief of pain after endoscopic submucosal dissection for gastric neoplasia: a randomized double-blind, placebo-controlled trial. Surg Endosc. 2015;29(3):714–22.CrossRefPubMed Kim B, Lee H, Chung H, Park JC, Shin SK, Lee SK, et al. The efficacy of topical bupivacaine and triamcinolone acetonide injection in the relief of pain after endoscopic submucosal dissection for gastric neoplasia: a randomized double-blind, placebo-controlled trial. Surg Endosc. 2015;29(3):714–22.CrossRefPubMed
9.
go back to reference Kim JE, Choi JB, Koo BN, Jeong HW, Lee BH, Kim SY. Efficacy of intravenous lidocaine during endoscopic submucosal dissection for gastric neoplasm: a randomized, double-blind, controlled study. Medicine (Baltimore). 2016;95(18):e3593.CrossRefPubMed Kim JE, Choi JB, Koo BN, Jeong HW, Lee BH, Kim SY. Efficacy of intravenous lidocaine during endoscopic submucosal dissection for gastric neoplasm: a randomized, double-blind, controlled study. Medicine (Baltimore). 2016;95(18):e3593.CrossRefPubMed
10.
go back to reference Chen J, Tu Q, Miao S, Zhou Z, Hu S. Transcutaneous electrical acupoint stimulation for preventing postoperative nausea and vomiting after general anesthesia: a meta-analysis of randomized controlled trials. Int J Surg. 2020;73:57–64.CrossRefPubMed Chen J, Tu Q, Miao S, Zhou Z, Hu S. Transcutaneous electrical acupoint stimulation for preventing postoperative nausea and vomiting after general anesthesia: a meta-analysis of randomized controlled trials. Int J Surg. 2020;73:57–64.CrossRefPubMed
11.
go back to reference Lu Z, Dong H, Wang Q, Xiong L. Perioperative acupuncture modulation: more than anaesthesia. Br J Anaesth. 2015;115(2):183–93.CrossRefPubMed Lu Z, Dong H, Wang Q, Xiong L. Perioperative acupuncture modulation: more than anaesthesia. Br J Anaesth. 2015;115(2):183–93.CrossRefPubMed
12.
go back to reference Meng D, Mao Y, Song QM, Yan CC, Zhao QY, Yang M, et al. Efficacy and safety of Transcutaneous Electrical Acupoint Stimulation (TEAS) for postoperative pain in laparoscopy: a systematic review and meta-analysis of randomized controlled trials. Evid Based Complement Alternat Med. 2022;2022:9922879.CrossRefPubMedPubMedCentral Meng D, Mao Y, Song QM, Yan CC, Zhao QY, Yang M, et al. Efficacy and safety of Transcutaneous Electrical Acupoint Stimulation (TEAS) for postoperative pain in laparoscopy: a systematic review and meta-analysis of randomized controlled trials. Evid Based Complement Alternat Med. 2022;2022:9922879.CrossRefPubMedPubMedCentral
13.
go back to reference Nielsen A, Dusek JA, Taylor-Swanson L, Tick H. Acupuncture therapy as an evidence-based nonpharmacologic strategy for comprehensive acute pain care: the academic consortium pain task force white paper update. Pain Med. 2022;23(9):1582–612.CrossRefPubMedPubMedCentral Nielsen A, Dusek JA, Taylor-Swanson L, Tick H. Acupuncture therapy as an evidence-based nonpharmacologic strategy for comprehensive acute pain care: the academic consortium pain task force white paper update. Pain Med. 2022;23(9):1582–612.CrossRefPubMedPubMedCentral
14.
go back to reference Bai YF, Gao C, Li WJ, Du Y, An LX. Transcutaneous electrical acupuncture stimulation (TEAS) for gastrointestinal dysfunction in adults undergoing abdominal surgery: study protocol for a prospective randomized controlled trial. Trials. 2020;21(1):617.CrossRefPubMedPubMedCentral Bai YF, Gao C, Li WJ, Du Y, An LX. Transcutaneous electrical acupuncture stimulation (TEAS) for gastrointestinal dysfunction in adults undergoing abdominal surgery: study protocol for a prospective randomized controlled trial. Trials. 2020;21(1):617.CrossRefPubMedPubMedCentral
15.
go back to reference Li WJ, Gao C, An LX, Ji YW, Xue FS, Du Y. Perioperative transcutaneous electrical acupoint stimulation for improving postoperative gastrointestinal function: a randomized controlled trial. J Integr Med. 2021;19(3):211–8.CrossRefPubMed Li WJ, Gao C, An LX, Ji YW, Xue FS, Du Y. Perioperative transcutaneous electrical acupoint stimulation for improving postoperative gastrointestinal function: a randomized controlled trial. J Integr Med. 2021;19(3):211–8.CrossRefPubMed
16.
go back to reference Xiong W, Zhao CM, An LX, Xie SN, Jia CR. Efficacy of acupuncture combined with local anesthesia in ischemic stroke patients with carotid artery stenting: a prospective randomized trial. Chin J Integr Med. 2020;26(8):609–16.CrossRefPubMed Xiong W, Zhao CM, An LX, Xie SN, Jia CR. Efficacy of acupuncture combined with local anesthesia in ischemic stroke patients with carotid artery stenting: a prospective randomized trial. Chin J Integr Med. 2020;26(8):609–16.CrossRefPubMed
17.
go back to reference Choi HS, Kim KO, Chun HJ, Keum B, Seo YS, Kim YS, et al. The efficacy of transdermal fentanyl for pain relief after endoscopic submucosal dissection: a prospective, randomised controlled trial. Dig Liver Dis. 2012;44(11):925–9.CrossRefPubMed Choi HS, Kim KO, Chun HJ, Keum B, Seo YS, Kim YS, et al. The efficacy of transdermal fentanyl for pain relief after endoscopic submucosal dissection: a prospective, randomised controlled trial. Dig Liver Dis. 2012;44(11):925–9.CrossRefPubMed
18.
go back to reference Kim SY, Jung SW, Choe JW, Hyun JJ, Jung YK, Koo JS, et al. Predictive factors for pain after endoscopic resection of gastric tumors. Dig Dis Sci. 2016;61(12):3560–4.CrossRefPubMed Kim SY, Jung SW, Choe JW, Hyun JJ, Jung YK, Koo JS, et al. Predictive factors for pain after endoscopic resection of gastric tumors. Dig Dis Sci. 2016;61(12):3560–4.CrossRefPubMed
19.
go back to reference Jung DH, Youn YH, Kim JH, Park H. Factors influencing development of pain after gastric endoscopic submucosal dissection: a randomized controlled trial. Endoscopy. 2015;47(12):1119–23.CrossRefPubMed Jung DH, Youn YH, Kim JH, Park H. Factors influencing development of pain after gastric endoscopic submucosal dissection: a randomized controlled trial. Endoscopy. 2015;47(12):1119–23.CrossRefPubMed
20.
go back to reference Green CR, Hart-Johnson T, Loeffler DR. Cancer-related chronic pain: examining quality of life in diverse cancer survivors. Cancer. 2011;117(9):1994–2003.CrossRefPubMed Green CR, Hart-Johnson T, Loeffler DR. Cancer-related chronic pain: examining quality of life in diverse cancer survivors. Cancer. 2011;117(9):1994–2003.CrossRefPubMed
21.
go back to reference Turk DC. Clinical effectiveness and cost-effectiveness of treatments for patients with chronic pain. Clin J Pain. 2002;18(6):355–65.CrossRefPubMed Turk DC. Clinical effectiveness and cost-effectiveness of treatments for patients with chronic pain. Clin J Pain. 2002;18(6):355–65.CrossRefPubMed
22.
go back to reference Abe S, Oda I, Suzuki H, Nonaka S, Yoshinaga S, Nakajima T, et al. Long-term surveillance and treatment outcomes of metachronous gastric cancer occurring after curative endoscopic submucosal dissection. Endoscopy. 2015;47(12):1113–8.CrossRefPubMed Abe S, Oda I, Suzuki H, Nonaka S, Yoshinaga S, Nakajima T, et al. Long-term surveillance and treatment outcomes of metachronous gastric cancer occurring after curative endoscopic submucosal dissection. Endoscopy. 2015;47(12):1113–8.CrossRefPubMed
23.
go back to reference Onogi F, Araki H, Ibuka T, Manabe Y, Yamazaki K, Nishiwaki S, et al. “Transmural air leak”: a computed tomographic finding following endoscopic submucosal dissection of gastric tumors. Endoscopy. 2010;42(6):441–7.CrossRefPubMed Onogi F, Araki H, Ibuka T, Manabe Y, Yamazaki K, Nishiwaki S, et al. “Transmural air leak”: a computed tomographic finding following endoscopic submucosal dissection of gastric tumors. Endoscopy. 2010;42(6):441–7.CrossRefPubMed
24.
go back to reference Lee H, Cheoi KS, Chung H, Park JC, Shin SK, Lee SK, et al. Clinical features and predictive factors of coagulation syndrome after endoscopic submucosal dissection for early gastric neoplasm. Gastric Cancer. 2012;15(1):83–90.CrossRefPubMed Lee H, Cheoi KS, Chung H, Park JC, Shin SK, Lee SK, et al. Clinical features and predictive factors of coagulation syndrome after endoscopic submucosal dissection for early gastric neoplasm. Gastric Cancer. 2012;15(1):83–90.CrossRefPubMed
25.
go back to reference Probst A, Maerkl B, Bittinger M, Messmann H. Gastric ischemia following endoscopic submucosal dissection of early gastric cancer. Gastric Cancer. 2010;13(1):58–61.CrossRefPubMed Probst A, Maerkl B, Bittinger M, Messmann H. Gastric ischemia following endoscopic submucosal dissection of early gastric cancer. Gastric Cancer. 2010;13(1):58–61.CrossRefPubMed
26.
go back to reference Parkman HP, Jones MP. Tests of gastric neuromuscular function. Gastroenterology. 2009;136(5):1526–43.CrossRefPubMed Parkman HP, Jones MP. Tests of gastric neuromuscular function. Gastroenterology. 2009;136(5):1526–43.CrossRefPubMed
27.
go back to reference Wang Y, Yang JW, Yan SY, Lu Y, Han JG, Pei W, et al. Electroacupuncture vs sham electroacupuncture in the treatment of postoperative ileus after laparoscopic surgery for colorectal cancer: a multicenter, randomized clinical trial. JAMA Surg. 2022: e225674. https://doi.org/10.1001/jamasurg.2022.5674. Wang Y, Yang JW, Yan SY, Lu Y, Han JG, Pei W, et al. Electroacupuncture vs sham electroacupuncture in the treatment of postoperative ileus after laparoscopic surgery for colorectal cancer: a multicenter, randomized clinical trial. JAMA Surg. 2022: e225674. https://​doi.​org/​10.​1001/​jamasurg.​2022.​5674.
28.
go back to reference Gao W, Li W, Yan Y, Yang R, Zhang Y, Jin M, et al. Transcutaneous electrical acupoint stimulation applied in lower limbs decreases the incidence of paralytic ileus after colorectal surgery: a multicenter randomized controlled trial. Surgery. 2021;170(6):1618–26.CrossRefPubMed Gao W, Li W, Yan Y, Yang R, Zhang Y, Jin M, et al. Transcutaneous electrical acupoint stimulation applied in lower limbs decreases the incidence of paralytic ileus after colorectal surgery: a multicenter randomized controlled trial. Surgery. 2021;170(6):1618–26.CrossRefPubMed
29.
go back to reference Wang J, Xia Q, Zhu F, Huang W, Meng Y, Wang Y, et al. Effects of acupuncture on adverse events in colonoscopy: a systematic review and meta-analysis of randomized controlled trials. Pain Ther. 2022;11(4):1095–112.CrossRefPubMedPubMedCentral Wang J, Xia Q, Zhu F, Huang W, Meng Y, Wang Y, et al. Effects of acupuncture on adverse events in colonoscopy: a systematic review and meta-analysis of randomized controlled trials. Pain Ther. 2022;11(4):1095–112.CrossRefPubMedPubMedCentral
Metadata
Title
Effects of transcutaneous electrical acupoint stimulation (TEAS) on postoperative pain in patients undergoing gastric and esophageal ESD surgery: a study protocol for a prospective randomized controlled trial
Authors
Xin-Lu Chang
Xu-Ming Liu
Li-Xin An
Jian-Yong Zheng
Ke Zhang
Publication date
01-12-2023
Publisher
BioMed Central
Keyword
Acupuncture
Published in
BMC Complementary Medicine and Therapies / Issue 1/2023
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-023-04075-9

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