Effectiveness of Perioperative Electrotherapy on Arrhythmia After Pneumonectomy:A Randomized Controlled Trial
Objective To study the effect of perioperative electroacupuncture(EA)intervention on arrhythmia after pneumonectomy and the influence of risk on new-onset arrhythmia.Methods A total of 314 lung cancer patients who received pneumonectomy from Jan,2020 to Oct,2022 were included,and they were assigned to the control group(157 cases)and EA group(157 cases)according to the random number table.Patients in the control group received conventional perioperative treatment,while those in the EA group received EA at Neiguan(PC6),Waiguan(SJ5),Xinshu(BL15),Shenmen(HT7),Tongli(HT5),Chize(LU5)and Hegu(LI4)combined with conventional treatment.The occurrence of arrhythmia in the 2 groups were compared.The serum level of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CPR),NT-pro brain natriuretic peptide(NT-proBNP)were detected.Visual analogue scale(VAS)was used to assess pain score.Multivariate Logistic regression was used to analyze the effect of high-risk factors of EA for arrhythmia after pneumonectomy during the perioperative period.Results Compared with before surgery,IL-6,TNF-α,hs-CPR,NT-proBNP and VAS pain score in the 2 groups decreased when awake from anesthesia(P＜0.01).Compared with the control group,the incidence of ventricular and atrial premature beats,and the total incidence of arrhythmia decreased in EA group(P＜0.05,P＜0.01),IL-6,TNF-α,hs-CPR,NT-proBNP and VAS pain score decreased in EA group when awake from anesthesia(P＜0.01),and the difference value of IL-6,TNF-α,hs-CPR,NT-proBNP and VAS pain score between before and after operation increased in EA group(P＜0.01).Multivariate Logistic regression analysis showed that the increasing of IL-6[OR=2.030,95％CI(1.250,3.297)],TNF-α[OR=3.147,95％CI(1.391,7.118)],hs-CPR[OR=1.972,95％CI(1.078,3.609)]and NT-proBNP[OR=1.683,95％CI(1.013,2.796)]when awake from anesthesia were risk factors for arrhythmia after pneumonectomy.The elevated differential values of TNF-α[OR=0.089,95％CI(0.011,0.741)]and hs-CPR[OR=0.242,95％CI(0.084,0.695)]were protective factors for arrhythmias after pneumonectomy.Conclusions Perioperative EA therapy can effectively reduce the incidence of arrhythmia and provide a new strategy for the prevention of arrhythmia after pneumonectomy.(Chinese Clinical Trial Registry,No.ChiCTR2100047499).
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