Highlights
- •EA is potentially valuable addition to ERAS for preoperative anxiety.
- •Preoperative EA alleviated anxiety and improved sleep quality.
- •Combination of pre- and intraoperative EA may improve postoperative quality of life.
Abstract
Background
To evaluate the effect of electroacupuncture (EA) based on enhanced recovery after
surgery on preoperative anxiety in patients undergoing breast cancer surgery.
Patients and Methods
This was a single-center, randomized, controlled, single-blind clinical trial. Between
December 2018 and 2019, 144 female undergoing breast conserving surgery were assigned
to conventional (A), preoperative EA (B), intraoperative EA (C), and combination of
preoperative and intraoperative EA (D) groups. Primary outcome was the self-rating
anxiety scale. Secondary outcomes included visual analogue scale, quality of recovery
40, postoperative complications, and acupuncture-related adverse reactions.
Results
141 patients completed the trial. Groups B and D self-rating anxiety scale were significantly
lower than A and C (P < .01); the sleep quality was significantly better (P < .01). The incidence of nausea at 6 hours postoperatively was significantly lower
in group D than other groups (P < .007); the incidence of vomiting at 6 hours postoperatively was better than group
A (P < .007). visual analogue scale at 24 hours postoperatively was significantly different
between groups A, B, and D (P < .01). Quality of recovery 40 total score at 24 hours postoperatively in group D
was significantly higher than A and B (P < .05). The 72-hour postoperative emotional state was most significantly improved
in group D (P < .05), while groups B and C showed interactive effect (P < .05).
Conclusion
Preoperative EA alleviated anxiety in the preoperative waiting area, and improved
sleep quality. Combination of preoperative and intraoperative EA may be more effective
in improving postoperative quality of life.
Trial registration
Chinese Clinical Trial Registry, ChiCTR1800019979. Registered on December 10, 2018.
(http://www.chictr.org.cn/edit.aspx?pid=27653&htm=4).
Keywords
Abbreviations:
ERAS (Enhanced recovery after surgery), SAS (Self-rating anxiety scale), VAS (Visual Analogue Scale), TCM (Traditional Chinese medicine), PONV (Postoperative nausea and vomiting)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical Breast CancerAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Breast cancer statistics, 2017, racial disparity in mortality by state.CA Cancer J Clin. 2017; 67: 439-448https://doi.org/10.3322/caac.21412
- Clinical diagnosis and management of breast cancer.J Nucl Med. 2016; 57 (Suppl 1): 9s-16shttps://doi.org/10.2967/jnumed.115.157834
- Health-related quality of life in a cohort of breast cancer survivors over more than 10 years post-diagnosis and in comparison to a control cohort.Cancers (Basel). 2021; 13https://doi.org/10.3390/cancers13081854
- Exploiting the critical perioperative period to improve long-term cancer outcomes.Nat Rev Clin Oncol. 2015; 12: 213-226https://doi.org/10.1038/nrclinonc.2014.224
- Relationship between preoperative antidepressant and antianxiety medications and postoperative hospital length of stay.Anesth Analg. 2019; 128: 248-255https://doi.org/10.1213/ane.0000000000003910
- Anxiety in women with breast cancer undergoing treatment: a systematic review.Int J Evid Based Healthc. 2011; 9: 215-235https://doi.org/10.1111/j.1744-1609.2011.00221.x
- A randomised controlled trial examining the effect of acupuncture at the EX-HN3 (Yintang) point on pre-operative anxiety levels in neurosurgical patients.Anaesthesia. 2017; 72: 335-342https://doi.org/10.1111/anae.13785
- American society for enhanced recovery and perioperative quality initiative-4 joint consensus statement on persistent postoperative opioid use: definition, incidence, risk factors, and health care system initiatives.Anesth Analg. 2019; 129: 543-552https://doi.org/10.1213/ane.0000000000003941
- A procedure-specific systematic review and consensus recommendations for postoperative analgesia following laparoscopic cholecystectomy.Surg Endosc. 2005; 19: 1396-1415https://doi.org/10.1007/s00464-004-2173-8
- Postoperative pain management in the era of ERAS: an overview.Best Pract Res Clin Anaesthesiol. 2019; 33: 259-267https://doi.org/10.1016/j.bpa.2019.07.016
- Guidelines for perioperative care in cardiac surgery: enhanced recovery after surgery society recommendations.JAMA Surg. 2019; 154: 755-766https://doi.org/10.1001/jamasurg.2019.1153
- Impact of enhanced recovery after surgery and fast track surgery pathways on healthcare-associated infections: results from a systematic review and meta-analysis.Ann Surg. 2017; 265: 68-79https://doi.org/10.1097/sla.0000000000001703
- Effect of enhanced recovery after surgery on postoperative recovery and quality of life in patients undergoing laparoscopic partial nephrectomy.Front Oncol. 2020; 10513874https://doi.org/10.3389/fonc.2020.513874
- Effects of transcutaneous electrical acupoint stimulation (teas) on postoperative recovery in patients with gastric cancer: a randomized controlled trial.Cancer Manag Res. 2021; 13: 1449-1458https://doi.org/10.2147/cmar.S292325
- Efficacy of transcutaneous electrical acupoint stimulation combined with general anesthesia for sedation and postoperative analgesia in minimally invasive lung cancer surgery: a randomized, double-blind, placebo-controlled trial.Thorac Cancer. 2020; 11: 928-934https://doi.org/10.1111/1759-7714.13343
- Can acupuncture therapy reduce preoperative anxiety? A systematic review and meta-analysis.J Integr Med. 2021; 19: 20-28https://doi.org/10.1016/j.joim.2020.10.007
- Sedative effect of acupuncture during cataract surgery: prospective randomized double-blind study.J Cataract Refract Surg. 2006; 32: 1951-1954https://doi.org/10.1016/j.jcrs.2006.06.027
- Auricular acupuncture for treatment of preoperative anxiety in patients scheduled for ambulatory gynaecological surgery: a prospective controlled investigation with a non-randomised arm.Acupunct Med. 2018; 36: 222-227https://doi.org/10.1136/acupmed-2017-011456
- Guidelines on the diagnosis and treatment of breast cancer (2011 edition).Gland Surg. 2012; 1: 39-61https://doi.org/10.3978/j.issn.2227-684X.2012.04.07
- The science of meridians and acupoints. People’s Medical Publishing House, Beijing2012
- Cifa Jiufaxue. 2nd ed. scientific & technical publishers, Shanghai2013
- Medical Stastitics.Medical Stastitics. 2nd ed. Peking Union Medical College Press, Beijing2007
- Acupuncture and related techniques during perioperative period: a literature review.Complement Ther Med. 2016; 29: 48-55https://doi.org/10.1016/j.ctim.2016.09.013
- Effectiveness of integrating individualized and generic complementary medicine treatments with standard care versus standard care alone for reducing preoperative anxiety.J Clin Anesth. 2016; 29: 54-64https://doi.org/10.1016/j.jclinane.2015.10.017
- Patient reported outcome of adult perioperative anaesthesia in the United Kingdom: a cross-sectional observational study.Br J Anaesth. 2016; 117: 758-766https://doi.org/10.1093/bja/aew381
- Preoperative anxiety in adults - a cross-sectional study on specific fears and risk factors.BMC Psychiatry. 2020; 20: 140https://doi.org/10.1186/s12888-020-02552-w
- Auricular stimulation for preoperative anxiety - A systematic review and meta-analysis of randomized controlled clinical trials.J Clin Anesth. 2022; 76110581https://doi.org/10.1016/j.jclinane.2021.110581
- Effects of auriculotherapy and midazolam for anxiety control in patients submitted to third molar extraction.Int J Oral Maxillofac Surg. 2019; 48: 669-674https://doi.org/10.1016/j.ijom.2018.10.014
- Acupuncture as an adjunct for sedation during lithotripsy.J Altern Complement Med. 2007; 13: 241-246https://doi.org/10.1089/acm.2006.6262
- Extra-1 acupressure for children undergoing anesthesia.Anesth Analg. 2008; 107: 811-816https://doi.org/10.1213/ane.0b013e3181804441
- Acupuncture on Yintang point decreases preoperative anxiety.J Altern Complement Med. 2013; 19: 420-424https://doi.org/10.1089/acm.2012.0494
- A case study on preoperative acupuncture in reducing the risk of operation.Altern Ther Health Med. 2020; 26: 48-51
- Insomnia symptoms and short sleep predict anxiety and worry in response to stress exposure: a prospective cohort study of medical interns.Sleep Med. 2019; 55: 40-47https://doi.org/10.1016/j.sleep.2018.12.001
- How might circadian rhythms control mood? Let me count the ways.Biol Psychiatry. 2013; 74: 242-249https://doi.org/10.1016/j.biopsych.2013.02.019
- Trait anxiety and sleep-onset insomnia: evaluation of treatment using anxiety management training.J Psychosom Res. 2003; 54: 31-37https://doi.org/10.1016/s0022-3999(02)00568-8
- ASPAN'S evidence-based clinical practice guideline for the prevention and/or management of PONV/PDNV.J Perianesth Nurs. 2006; 21: 230-250https://doi.org/10.1016/j.jopan.2006.06.003
- Is 'anxiety sensitivity' predictive of postoperative nausea and vomiting?: A prospective observational study.Eur J Anaesthesiol. 2019; 36: 369-374https://doi.org/10.1097/eja.0000000000000979
- Does measurement of preoperative anxiety have added value for predicting postoperative nausea and vomiting?.Anesth Analg. 2005; 100: 1525-1532https://doi.org/10.1213/01.Ane.0000149325.20542.D4
- A multicenter survey of perioperative anxiety in China: Pre- and postoperative associations.J Psychosom Res. 2021; 147110528https://doi.org/10.1016/j.jpsychores.2021.110528
- Procedure-specific pain management and outcome strategies.Best Pract Res Clin Anaesthesiol. 2014; 28: 191-201https://doi.org/10.1016/j.bpa.2014.03.005
- Sham acupuncture is as efficacious as true acupuncture for the treatment of IBS: a randomized placebo controlled trial.Neurogastroenterol Motil. 2017; 29https://doi.org/10.1111/nmo.13040
Article Info
Publication History
Published online: April 29, 2022
Accepted:
April 25,
2022
Received:
February 9,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Qiu-yu Tong and Ran Liu contributed equally to this work as first authors.
Identification
Copyright
© 2022 Published by Elsevier Inc.