收稿日期: 2025-06-04
网络出版日期: 2025-09-05
基金资助
国家自然科学基金项目(82171227);浙江省自然科学基金项目(LY22H090019)
Effects of transcutaneous auricular vagus nerve stimulation on quality of early postoperative recovery in patients undergoing thoracoscopic lung resection
Received date: 2025-06-04
Online published: 2025-09-05
目的 探讨经皮耳迷走神经刺激（taVNS）对胸腔镜肺切除术患者术后早期恢复的影响。 方法 选取拟行全麻下择期胸腔镜肺切除术（肺楔形切、段切、叶切）的患者168例，随机分为taVNS组（T组）和假刺激组（S组）两组（n = 84）。在术前1 d下午、麻醉诱导前、术后恢复室拔管后、术后第1天下午两组患者分别接受连续4次刺激或者假刺激，每次刺激30 min。记录患者术后24、48、72 h的15项恢复质量评分量表（QoR-15）、静息和咳嗽时的数字等级评分量表（NRS）、术后48 h阿片类药物的用量、术后胸腔闭式引流管留置时间、严重肺部并发症发生率、术后住院时间及刺激的不良反应（恶心呕吐、发热、便秘、头晕、瘙痒等）发生情况。 结果 与S组相比，T组术后24、48、72 h的QoR-15评分升高，静息和咳嗽时的NRS评分减少，术后48 h内阿片类药物用量减少（P < 0.05）。两组患者术后胸腔引流管留置时间、严重肺部并发症的发生率、住院时间及刺激的不良反应发生率比较差异均无统计学意义（P > 0.05）。 结论 taVNS可显著提高胸腔镜肺切除术患者的术后早期恢复质量，且提供了更有效的术后镇痛，而不会增加术后并发症的风险。
孙正秀 , 汪媛媛 , 林永傲 , 马天喜 , 李平豪 , 周明开 , 曹君利 , 刘鹤 . 经皮耳迷走神经刺激对胸腔镜肺切除术患者术后早期恢复质量的影响[J]. 实用医学杂志, 2025 , 41(17) : 2670 -2675 . DOI: 10.3969/j.issn.1006-5725.2025.17.009
Objective To investigate the effect of transcutaneous auricular vagus nerve stimulation （taVNS） on quality of early postoperative recovery in patients undergoing thoracoscopic lung resection. Methods A total of 168 patients scheduled for elective thoracoscopic lung resection （wedge resection， segmentectomy， lobectomy） under general anesthesia were enrolled and randomly assigned to active?taVNS group （group T） or sham?taVNS group （group S） （n = 84）. Participants received four consecutive 30?minute sessions of active stimulation or sham stimulation at four time points： （1） the afternoon prior to the surgery， （2） the morning of the surgery， （3） following extubation， and （4） the first afternoon post?surgery. The Quality of Recovery?15 （QoR?15） scores of the patients， the Numerical Rating Scale （NRS） scores at rest and during cough at 24， 48， and 72 hours after surgery were recorded； and the usage of opioids within 48 hours after surgery was recorded； the duration of chest tube indwelling， incidence of severe pulmonary complications， postoperative hospital stay and adverse reactions to the stimulation （such as nausea and vomiting， fever， constipation， dizziness and itching） were observed. Results Compared with group S， group T exhibited significantly higher QoR?15 scores at 24， 48， and 72 h postoperatively， lower NRS pain scores during resting and coughing， and reduced opioid consumption within 48 hours postoperatively （P < 0.05）. There were no significant differences between the two groups in the duration of chest tube indwelling， incidence of severe pulmonary complications， hospital stay， and the incidence of adverse reactions to the stimulation （P > 0.05）. Conclusion TaVNS can significantly improve quality of early postoperative recovery in patients undergoing thoracoscopic lung resection， and provide more effective postoperative analgesia without increasing the risk of postoperative complications.
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