Effect of buccal acupuncture therapy on the incidence of postoperative delirium in older adults undergoing orthopedic lower limb surgery: A randomized controlled trial.
Study Goal
The researchers aimed to determine whether perioperative buccal acupuncture therapy could reduce the incidence of postoperative delirium in elderly patients undergoing orthopedic lower limb surgery.
Results Summary
The study found that buccal acupuncture significantly reduced the incidence of postoperative delirium (12% vs. 27% in controls) and lowered intraoperative opioid consumption, postoperative pain scores, and nausea/vomiting. Limitations include the single-center design and lack of long-term follow-up.
Population
Elderly patients (aged ≥65 years) scheduled for elective orthopedic lower limb surgery.
Effective Dosage
Buccal acupuncture administered 30 minutes before anesthesia induction until the end of surgery, and for 30 minutes daily for the first 2 postoperative days.
Duration
Acute intervention during surgery and short-term postoperative administration (2 days).
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
perioperative buccal acupuncture therapy | decrease | incidence of delirium during the first 7 postoperative days | elderly patients who underwent orthopedic lower limb surgery | 27% vs. 12%; relative risk, 0.44; 95% confidence interval, 0.19-0.99; P=0.037 | significantly lower | #1 |
perioperative buccal acupuncture therapy | decrease | intraoperative total consumption rate of sufentanil and remifentanil | elderly patients who underwent orthopedic lower limb surgery | - | significantly lower | #2 |
perioperative buccal acupuncture therapy | decrease | postoperative pain scores | elderly patients who underwent orthopedic lower limb surgery | - | significantly lower | #3 |
perioperative buccal acupuncture therapy | decrease | incidence of postoperative nausea and vomiting | elderly patients who underwent orthopedic lower limb surgery | - | significantly lower | #4 |
OBJECTIVE: This study evaluated the effect of perioperative buccal acupuncture therapy on the incidence of postoperative delirium in elderly patients who underwent orthopedic lower limb surgery. METHODS: This was a single-center, prospective, randomized controlled trial. A total of 120 elderly patients (aged ≥65 years) scheduled for elective orthopedic lower limb surgery were randomly assigned to the intervention group (n = 60, buccal acupuncture 30 min before anesthesia induction until the end of surgery and for 30 min each day for the first 2 postoperative days) or the control group (n = 60, no buccal acupuncture). The primary outcome was delirium during the first 7 postoperative days. The secondary outcomes included delirium severity, duration, and subtype; intraoperative total consumption rate of sufentanil and remifentanil; interleukin-6, interleukin-8, and norepinephrine in venous blood; the total number of electronic analgesia pump compressions; nausea and vomiting in 48 h; postoperative pain score; postoperative hospital stay, and postoperative adverse event rates. RESULTS: The data of 120 patients were collected. The incidence of delirium during the first 7 postoperative days was significantly lower in the intervention group than in the control group (27 % [16/60] vs. 12 % [7/60]; relative risk, 0.44; 95 % confidence interval, 0.19-0.99; P = 0.037). Intraoperative total consumption rate of sufentanil and remifentanil, postoperative pain scores, and the incidence of postoperative nausea and vomiting were significantly lower in the intervention group. CONCLUSION: Buccal acupuncture can reduce the incidence of postoperative delirium in elderly patients who undergo orthopedic lower limb surgery.