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Cough Suppression during Flexible Bronchoscopy Using Transcutaneous Electric Acupoint Stimulation: A Randomized

Wei Zhang1, Yi-Xiao Yang1, Wei Yu1

  • 1Department of Anesthesiology, The Fourth Affiliated Hospital of Harbin Medical University, Yiyuan Street 37#, Harbin 150001, Heilongjiang Province, China.

Evidence-Based Complementary and Alternative Medicine : Ecam
|December 13, 2019
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Summary

Transcutaneous electric acupoint stimulation (TEAS) effectively suppresses cough during flexible bronchoscopy (FB). This method, combined with midazolam, proved superior to midazolam alone, likely by increasing beta-endorphin levels.

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Area of Science:

  • Medical research
  • Acupuncture and related therapies
  • Respiratory medicine

Background:

  • Transcutaneous electric acupoint stimulation (TEAS) is recognized for sedative and analgesic properties.
  • Flexible bronchoscopy (FB) can induce significant coughing, impacting patient comfort and procedure efficiency.
  • Investigating non-pharmacological methods to mitigate FB-induced cough is clinically relevant.

Purpose of the Study:

  • To evaluate the efficacy of TEAS in suppressing cough during flexible bronchoscopy.
  • To explore the potential mechanism of TEAS in cough suppression.
  • To compare TEAS combined with midazolam versus midazolam alone for FB.

Main Methods:

  • A single-center, randomized, single-blind, parallel-controlled study involving 100 patients undergoing FB.
  • Patients were divided into two groups: one receiving TEAS (at LI4, PC6, LU7 points) for 30 minutes before FB, and a control group without stimulation.
  • Primary outcome was the intraoperative cough score; secondary outcomes included patient-reported discomfort and procedural parameters.

Main Results:

  • TEAS preconditioning significantly reduced intraoperative cough scores (P=0.0027) and the need for lidocaine and fentanyl compared to controls.
  • Post-procedure plasma β-endorphin levels were significantly higher in the TEAS group (P=0.0367).
  • TEAS group showed reduced procedure duration and time for bronchoscope passage through vocal cords, with no significant differences in discomfort or complications.

Conclusions:

  • TEAS in combination with midazolam is more effective for cough suppression during FB than midazolam alone.
  • The enhanced cough suppression is likely mediated by increased plasma β-endorphin levels.
  • TEAS offers a promising adjunct for improving FB procedures.