[Application of Transcutaneous Electrical Acupoint Stimulation Combined with Transversus Abdominis Plane Block to Enhanced Recovery After Surgery in Patients Undergoing Laparoscopic Colorectal Cancer Resection: A Randomized Controlled Clinical Trial].

Objective: To explore the effect of transcutaneous electrical acupoint stimulation (TEAS) combined with transversus abdominis plane (TAP) block in the enhanced recovery after surgery (ERAS) in patients undergoing laparoscopic colorectal cancer resection (LCCR).

Methods: A total of 101 patients undergoing LCCR were randomly divided into three groups: control (＝34), TAP (＝35) and TEAS＋TAP (＝32). Conventional perioperative anesthesia management of the 3 groups was performed according to the ERAS guidelines. All the patients experienced patient controlled epidural analgesia (PCEA), and those of the TAP and TEAS＋TAP groups received TAP block by injection of 0.3% Roperca hydrochloride (15 mL) into the space between the internal oblique and the transverse abdominis after induction of anesthesia. For patients of the TEAS＋TAP group, TEAS (2 Hz/10 Hz, an endurable stimulation strength) was applied to bilateral Zusanli (ST 36) from 30 min before anesthesia to the end of the surgery. The blood glucose value and dosage of Remifentanil used were recorded. The pain severity was assessed at 4, 12, 24 and 48 h after surgery by using visual analogue scale (VAS). Moreover, postoperative anal exhaust time, postoperative oral feeding time, postoperative first ambulation time and postoperative hospital stay length were recorded.

Results: The total dosages of Remifentanil used during surgery, and the blood glucose levels were significantly lower in the TAP and TEAS＋TAP groups than in the control group (<0.05), but had no significant differences between the TAP and TEAS＋TAP groups (>0.05). The VAS scores of the TAP and TEAS＋TAP groups were considerably lower than those of the control group at 4, 12, 24 and 48 h after surgery (<0.05, except 48 h of TAP group). Of the 34, 35 and 32 cases in the control, TAP and TEAS＋TAP groups, 5(14.7%), 3(8.6%) and 1(3.1%) on the 1 day post-surgery, and 2(5.9%), 0(0) and 0(0) on the 2 day after surgery experienced nausea and vomiting. The postoperative anal exhaust time and postoperative oral feeding time were significantly earlier in both TAP and TEAS＋TAP groups than in the control group (<0.05), and the exhaust time of the TEAS＋TAP group was even earlier than that of the TAP group (<0.05). No significant differences were found among the 3 groups in the postoperative ambulation time and postoperative hospitalization time (>0.05).

Conclusion: TEAS combined with TAP block analgesia is superior to simple TAP block analgesia in relieving postoperative pain, shortening the recovery time of gastrointestinal function and promoting postoperative rehabilitation in patients undergoing LCCR.