Effects of Electroacupuncture Combined with General Anesthesia on Postoperative Neurocognitive Dysfunction and Inflammatory Factors in Elderly Patients: a Meta-analysis

Objective:To systematically review the effects of electroacupuncture on neurocognitive dysfunction and inflammatory factors in elderly patients after general anesthesia.Methods:Computer retrieval of EMBASE,The Cochrane Library,PubMed,Web of Science,CBM,CNKI,Wanfang Data,and VIP databases.The time limit was until April 17,2021.The literature on the effect of electroacupuncture on postoperative neurocognitive dysfunction in elderly patients was searched.Two researchers separately strictly screened and evaluated the included literature,and then analyzed them using RevMan 5.3 software.Results:Electroacupuncture improved the MMSE score on the first[SMD=2.08,95%CI(1.14,3.02),P<0.0001]and third days[SMD=0.87,95%CI(0.15,1.59),P=0.02]after surgery;the incidence of PNCD on the first[OR=0.37,95%CI(0.26,0.54),P<0.00001]and third days[OR=0.37,95%CI(0.25,0.56),P<0.00001]after surgery were reduced;IL-6 expression at the end of the operation[SMD=-0.96,95%CI(-1.88,-0.04),P=0.04]was reduced;accelerated the recovery time from anesthesia[SMD=-1.15,95%CI(-1.43,-0.87),P<0.00001];the incidence of postoperative nausea and vomiting[OR=0.39,95%CI(0.20,0.78),P=0.007]was reduced.Compared with the control group,the expression of IL-6 on the first[SMD=-0.24,95%CI(-0.83,0.36),P=0.43]and second days[SMD=-0.35,95%CI(-0.93,0.23),P=0.24]after operation,and the expression of TNF-αat the end of operation[SMD=-0.65,95%CI(-1.33,0.03),P=0.06]and the first day[SMD=-0.51,95%CI(-1.02,-0.01),P=0.05]after operation had no statistically significant difference.Conclusion:Electroacupuncture can effectively reduce the incidence of postoperative neurocognitive dysfunction and postoperative nausea and vomiting in elderly patients,and accelerate the recovery time from anesthesia.The difference in the frequency and duration of electroacupuncture may potentially affect clinical efficacy.

椎管内麻醉与全身麻醉对髋部骨折患者术后谵妄影响的Meta分析

目的系统评价椎管内麻醉(SA)与全身麻醉(GA)对髋部骨折患者术后谵妄的影响。方法系统检索PubMed、Cochranelibrary、Web of science和Embase4个数据库,搜集建库至2022年2月有关SA和GA应用于髋部骨折手术对术后谵妄影响的随机对照研究文献。由2名研究人员独立完成文献筛选、数据提取和文献质量评价,并采用RevMan5.4软件进行Meta分析。结果共纳入9篇随机对照研究文献,患者3235例,其中SA组1610例,GA组1625例。Meta分析显示:SA组和GA组术后4 d和7 d的谵妄发生率比较,差异无统计学意义(RR=1.03、1.05,95%CI:0.67~1.60、0.89~1.25,P>0.05);两组总住院时间、术后3个月死亡率比较,差异均无统计学意义(P>0.05)。结论与GA相比,SA不能降低髋部骨折术后4 d和7 d谵妄发生率、术后3个月死亡率及总住院时间。