Transcutaneous electric nerve stimulation of acupuncture points improves tolerance in adults undergoing diagnostic upper gastrointestinal endoscopy: a single-center, double-blinded, randomized controlled trial.

Autor: Chuah JS; Department of General Surgery, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000, Kuala Lumpur, Malaysia. Vincentchuahjs@gmail.com.; Department of General Surgery, Hospital Sultanah Aminah Johor Bahru, Ministry of Health Malaysia, Jalan Persiaran Abu Bakar Sultan, 80100, Johor Bahru, Johor, Malaysia. Vincentchuahjs@gmail.com., Tan JH; Department of General Surgery, Hospital Sultanah Aminah Johor Bahru, Ministry of Health Malaysia, Jalan Persiaran Abu Bakar Sultan, 80100, Johor Bahru, Johor, Malaysia., Bujang MA; Clinical Research Centre, Sarawak General Hospital, Kuching, Sarawak, Ministry of Health Malaysia, Kuching, Malaysia., Chan KK; Department of General Surgery, Hospital Sultanah Aminah Johor Bahru, Ministry of Health Malaysia, Jalan Persiaran Abu Bakar Sultan, 80100, Johor Bahru, Johor, Malaysia., Kosai NR; Department of General Surgery, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000, Kuala Lumpur, Malaysia.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2024 Jun; Vol. 38 (6), pp. 3279-3287. Date of Electronic Publication: 2024 Apr 24.
DOI: 10.1007/s00464-024-10841-8
Abstrakt: Background: Oesophagogastroduodenoscopy (OGDS) is the most common diagnostic procedure for upper gastrointestinal diseases. It often causes discomfort and anxiety, which are only mitigated by systemic sedation. However, sedation poses additional risks of adverse cardiopulmonary events, increased medical costs, and prolonged recovery. Transcutaneous electrical nerve stimulation of acupuncture points (Acu-TENS) is a non-invasive and innovative approach that induces analgesic effect during endoscopy. This trial is the first to be reported in English that explores the potential of Acu-TENS to increase patient tolerance during non-sedated elective diagnostic OGDS.
Methods: A double-blinded randomized controlled trial involving 348 subjects was conducted at a tertiary hospital to evaluate the success rate of OGDS with Acu-TENS. Subjects aged 18-75 years scheduled for their first elective diagnostic OGDS were randomized into the intervention (Acu-TENS) and placebo arms. OGDS success was assessed based on subjects' satisfaction ratings on a Likert scale and procedure's technical adequacy. Secondary measures included subjects' willingness to undergo future OGDS under similar conditions, procedure duration, and the endoscopist's perceived ease of the procedure.
Results: OGDS success rates were significantly higher with Acu-TENS (77.8%) than with the placebo (68.0%; odds ratio [OR] 1.64, 95% confidence interval [CI] 1.01-2.66, p = 0.043). Subjects who received Acu-TENS expressed higher willingness for future OGDS (78.9%) than those who received the placebo (68.6%; OR 1.71, 95% CI 1.04-2.79, p = 0.031). Procedure duration were significantly shorter in the intervention arm (6.0 min) than in the placebo arm (10.0 min; p = 0.002). No adverse effects were reported, and endoscopists perceived similar procedure ease in both arms.
Conclusions: Acu-TENS improved OGDS success and enhanced patients' experiences during non-sedated OGDS. It demonstrated safety with no side effects and reduced the procedure completion time. It could be used as an adjunct in non-sedated diagnostic OGDS.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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