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Preoperative Transcutaneous Electrical Acupoint Stimulation Alleviates Postoperative Pain and Improves Sleep Quality
Can Ma1,2, Hong Xiong3, Wenchao Fu1
1The Key Laboratory of Anesthesiology and Intensive Care Research of Heilongjiang Province, Harbin, Heilongjiang, People's Republic of China.
Purpose:
Preoperative sleep disturbance exacerbates postoperative pain and delays recovery. Transcutaneous electrical acupoint stimulation (TEAS) may alleviate insomnia and pain. This trial evaluated preoperative TEAS on postoperative pain, sleep, and intraoperative hemodynamics in breast cancer patients with preoperative sleep disturbance.
Patients And Methods:
Fifty-nine breast cancer patients (aged 37-70 years) were stratified by Pittsburgh Sleep Quality Index (PSQI): PSQI < 6 were assigned to the non-randomized control group (Group C, n = 26), while patients with PSQI ≥ 6 were randomly allocated (1:1) to the sleep disturbance group (Group S, n = 16) or the TEAS group (Group T, n = 17). TEAS (2/100 Hz, 8-12 mA, 30 min) was delivered pre-anesthesia at LI4, HT7, and PC6. Pain was assessed via Numerical Rating Scale (NRS) at 4, 24, 48, and 72 h postoperatively. Sleep was measured with Athens Insomnia Scale (AIS). Intraoperative systolic blood pressure variability (sdSBP, cvSBP) was recorded.
Results:
In observational comparisons, Group S exhibited elevated NRS scores at 24, 48, and 72 h vs Group C (p < 0.05). TEAS significantly reduced NRS scores across all time points (p < 0.05) and improved AIS scores on postoperative days 1-2 (p < 0.05). Intraoperative sdSBP and cvSBP were lower in Group T than Group S (9.31 ± 2.73 vs 18.85 ± 6.74; 0.08 ± 0.02 vs 0.16 ± 0.05; p < 0.05). Among non-TEAS patients (Groups C and S), preoperative PSQI positively correlated with postoperative NRS and AIS scores.
Conclusion:
Preoperative TEAS significantly attenuates postoperative pain and improves sleep in breast cancer patients with preoperative sleep disturbance, possibly associated with reduced intraoperative blood pressure variability. Preoperative sleep quality may predict postoperative outcomes.