Transcutaneous electrical acupoint stimulation for reducing cognitive dysfunction in lumbar spine surgery: A...

Area of Science:

• Neurosurgery
• Geriatric Medicine
• Pain Management

Background:

• Postoperative cognitive dysfunction (POCD) is a significant concern in older patients following surgery.
• Lumbar spine surgery in elderly patients carries a risk of neurological complications, including POCD.
• Inflammatory markers are implicated in the pathophysiology of POCD.

Purpose of the Study:

• To evaluate the efficacy of perioperative transcutaneous electrical acupoint stimulation (TEAS) in preventing POCD in elderly patients undergoing lumbar spine surgery.
• To assess the impact of TEAS on key inflammatory biomarkers.

Main Methods:

• Randomized controlled trial involving older patients (60-80 years) undergoing lumbar spine surgery.
• Intervention groups received TEAS (3-day or 7-day) at "Baihui" (GV 20) and "Dazhui" (GV 14) points, while the control group received sham TEAS.
• Primary outcome: incidence of POCD assessed by Mini Mental Rating Scale (MMSE). Secondary outcomes: serum levels of IL-6, TNF-α, NSE, and S100β.

Main Results:

• The incidence of POCD was significantly lower in both TEAS groups compared to the sham group at 3 days post-surgery (22.4% and 18.3% vs. 42.9%).
• At 7 days post-surgery, the 7-day TEAS group showed a lower POCD incidence (18.3%) compared to the 3-day TEAS group (26.5%) and the sham group (42.9%).
• TEAS intervention significantly reduced serum levels of IL-6, TNF-α, NSE, and S100β compared to the sham group, although levels remained higher than pre-operative baseline.

Conclusions:

• Perioperative TEAS is effective in reducing the incidence of POCD in older patients undergoing lumbar spine surgery.
• TEAS appears to mitigate the inflammatory response associated with surgery, contributing to neuroprotection.
• A 7-day TEAS intervention may offer a more sustained benefit in preventing POCD compared to a 3-day intervention.