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Zhao L, Guo Y, Zhou X, Mao W, Zhu H, Chen L, Liu X, Zhang L, Xie Y, Li L. The research progress of perioperative non-pharmacological interventions on postoperative cognitive dysfunction: a narrative review. Front Neurol 2024; 15:1369821. [PMID: 38751891 PMCID: PMC11094646 DOI: 10.3389/fneur.2024.1369821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
Postoperative cognitive dysfunction (POCD) is a common neurological complication in elderly patients after surgery and general anesthesia. The occurrence of POCD seriously affects the postoperative recovery of patients, and leads to prolonged hospital stay, reduced quality of life, increased medical costs, and even higher mortality. There is no definite and effective drug treatment for POCD. More evidence shows that perioperative non-pharmacological intervention can improve postoperative cognitive function and reduce the incidence of POCD. Therefore, our studies summarize the current non-pharmacological interventions of POCD from the aspects of cognitive training, physical activity, transcutaneous electrical acupoint stimulation, noninvasive brain stimulation, non-pharmacological sleep improvement, music therapy, environment, and multimodal combination Interventions, to provide more data for clinical application and research.
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Affiliation(s)
- Li Zhao
- Department of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
| | - Yiping Guo
- School of Humanities and Management, Key Laboratory for Quality of Life and Psychological Assessment and Intervention, Guangdong Medical University, Dongguan, China
- Nanchong Center for Disease Control and Prevention, Nanchong, China
| | - Xuelei Zhou
- Department of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
| | - Wei Mao
- Department of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
| | - Hongyu Zhu
- Department of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
| | - Linlin Chen
- Department of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
| | - Xianchun Liu
- Department of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
| | - Longyi Zhang
- Department of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
| | - Ying Xie
- Department of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
| | - Linji Li
- Department of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
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Chen R, Huang L, Wang R, Fei J, Wang H, Wang J. Advances in Non-Invasive Neuromodulation Techniques for Improving Cognitive Function: A Review. Brain Sci 2024; 14:354. [PMID: 38672006 PMCID: PMC11048722 DOI: 10.3390/brainsci14040354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/27/2024] [Accepted: 03/30/2024] [Indexed: 04/28/2024] Open
Abstract
Non-invasive neuromodulation techniques are widely utilized to study and improve cognitive function, with the aim of modulating different cognitive processes. For workers performing high-intensity mental and physical tasks, extreme fatigue may not only affect their working efficiency but may also lead to cognitive decline or cognitive impairment, which, in turn, poses a serious threat to their physical health. The use of non-invasive neuromodulation techniques has important research value for improving and enhancing cognitive function. In this paper, we review the research status, existing problems, and future prospects of transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), transcranial magnetic stimulation (TMS), and transcutaneous acupoint stimulation (TAS), which are the most studied physical methods in non-invasive neuromodulation techniques to improve and enhance cognition. The findings presented in this paper will be of great reference value for the in-depth study of non-invasive neuromodulation techniques in the field of cognition.
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Affiliation(s)
- Ruijuan Chen
- School of Life Sciences, Tiangong University, Tianjin 300387, China; (R.C.); (H.W.)
| | - Lengjie Huang
- School of Electronics & Information Engineering, Tiangong University, Tianjin 300387, China; (L.H.); (R.W.); (J.F.)
| | - Rui Wang
- School of Electronics & Information Engineering, Tiangong University, Tianjin 300387, China; (L.H.); (R.W.); (J.F.)
| | - Jieying Fei
- School of Electronics & Information Engineering, Tiangong University, Tianjin 300387, China; (L.H.); (R.W.); (J.F.)
| | - Huiquan Wang
- School of Life Sciences, Tiangong University, Tianjin 300387, China; (R.C.); (H.W.)
| | - Jinhai Wang
- School of Life Sciences, Tiangong University, Tianjin 300387, China; (R.C.); (H.W.)
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Huang KY, Liang S, Du HG, Xu YY, Chen L, Zhang Y, Feng XX. Transcutaneous electrical acupoint stimulation for prevention of postoperative urinary retention: A systematic review. Heliyon 2024; 10:e23537. [PMID: 38169833 PMCID: PMC10758783 DOI: 10.1016/j.heliyon.2023.e23537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Transcutaneous electrical acupoint stimulation (TEAS) has been proposed for postoperative urinary retention (POUR). This meta-analysis evaluated the effect of TEAS in preventing POUR. Methods Databases were searched until February 6, 2023. Randomized controlled trials (RCTs) about TEAS for preventing POUR were included. The primary concern was the incidence of POUR, with post-void residual urine volume as a secondary outcome. Results Fourteen studies with 2865 participants were identified. TEAS reduced the incidence of POUR (RR = 0.44, 95%CI = 0.33 to 0.58, P < 0.00001) and decreased the post-void residual urine volume (MD = -75.41 mL, 95%CI = -118.76 to -32.06, P = 0.0007). The preventive effect on POUR was found in patients receiving anorectal, gynecologic, orthopedic and biliary surgery, but not urinary surgery. Dilatational- and continuous-wave TEAS had a great outcome in preventing POUR. Intraoperative TEAS, preoperative and intraoperative TEAS, and postoperative TEAS were beneficial, and TEAS was more beneficial when compared with sham TEAS and blank control. It is nevertheless difficult to rule out publication bias. Conclusions TEAS could prevent POUR. Due to insufficient evidence, multicenter, large-sample and high-quality RCTs should be conducted. (Registration:INPLASY202320095).
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Affiliation(s)
- Kai-Yu Huang
- Acupuncture Department, Ningbo Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China
| | - Shuang Liang
- Acupuncture Department, Ningbo Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China
| | - Han-Guang Du
- Endocrinology Department, Ningbo Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China
| | - Yong-Yi Xu
- Acupuncture Department, Ningbo Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China
| | - Lei Chen
- Acupuncture Department, Ningbo Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China
| | - Yi Zhang
- Acupuncture Department, Ningbo Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China
| | - Xin-Xin Feng
- Acupuncture Department, Ningbo Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China
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Wang B, Peng G, Chen L, Guo M, Zhou J, Liu Y, Chen Z, Wang L. Effect of transcutaneous electrical acupoint stimulation on remifentanil dosage during craniotomy aneurysm clipping: a prospective, randomized controlled study. BMC Complement Med Ther 2023; 23:453. [PMID: 38093254 PMCID: PMC10717748 DOI: 10.1186/s12906-023-04297-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/06/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Craniotomy aneurysm clipping is one of the main treatments for intracranial aneurysm (IA). Endotracheal intubation and intraoperative operation may induce dramatic hemodynamic fluctuations and increase the risk of aneurysm rupture. Intraoperative high-dose opioid use is the main measure to reduce the intraoperative stress response, but it increases the incidence of complications such as postoperative vomiting and delayed awakening. Transcutaneous electrical acupoint stimulation (TEAS) stimulates β-endorphin expression levels and reduces opioid requirements. In this study, we aimed to assess the effects of TEAS on remifentanil dosage and oxidative stress (OS) in craniotomy aneurysm clipping. METHOD Forty-two patients with craniotomy aneurysm clipping were randomized into two groups: the TEAS group (T group) and the sham TEAS group (S group). "Hegu" (LI4), "Neiguan" (PC6) and "Zusanli" points (ST36) were selected, and a "HANS" percutaneous acupoint electrical stimulator was used for intervention 30 min before anesthesia induction until the end of the operation. The primary outcome was intraoperative remifentanil dosage. The secondary outcomes were intraoperative propofol dosage, mean arterial pressure (MAP) and heart rate (HR) 5 min before the TEAS intervention (T0), 5 min before head holder pinning (T1), immediately after pinning (T2), 5 min before craniotomy (T3), immediately after craniotomy (T4), at craniotomy (T5), and at the end of surgery (T6), as well as serum β-endorphin levels at T1, T2 and T6 and neuron-specific enolase (NSE), S100β, superoxide dismutase (SOD) and malondialdehyde (MDA) levels at T1, T2 and 24 h after surgery (T7). RESULTS The dosage of remifentanil in the T group was reduced compared to that in the S group (P < 0.05). At T2, T4 and T5, the MAP and HR in the T group were lower than those in the S group (P < 0.05). At T2 and T7, the levels of NSE, S100β and MDA in group T were lower than those in group S (P < 0.05), while the SOD levels in group T were higher than those in group S (P < 0.05). CONCLUSIONS The use of TEAS can reduce the dosage of remifentanil and reduce hemodynamic fluctuations during craniotomy aneurysm clipping. It reduces the occurrence of OS and central nervous system damage during surgery and has a certain brain protective effect. TRIAL REGISTRATION ChiCTR2100052353. https://www.chictr.org.cn/about.html .
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Affiliation(s)
- Bingyu Wang
- The First Clinical College of Medicine, Gannan Medical University, Ganzhou, 34100, China
- The Second Hospital of Ningbo, Ningbo, 315100, China
| | - Guanfa Peng
- The First Clinical College of Medicine, Gannan Medical University, Ganzhou, 34100, China
| | - Li Chen
- Department of Anesthesiology, The First Affiliated Hospital of Gannan Medical University, No. 128, Jinling West Road, Ganzhou, 34100, China
| | - Mingling Guo
- The First Clinical College of Medicine, Gannan Medical University, Ganzhou, 34100, China
| | - Jianshun Zhou
- The First Clinical College of Medicine, Gannan Medical University, Ganzhou, 34100, China
| | - Yingying Liu
- The First Clinical College of Medicine, Gannan Medical University, Ganzhou, 34100, China
| | - Zhen Chen
- The First Clinical College of Medicine, Gannan Medical University, Ganzhou, 34100, China
| | - Lifeng Wang
- Department of Anesthesiology, The First Affiliated Hospital of Gannan Medical University, No. 128, Jinling West Road, Ganzhou, 34100, China.
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