Acupoint Stimulation Improve Postoperative Delirium in Elderly Patients
Condition: Postoperative Complications; Postoperative Delirium
MeSH terms: Delirium; Emergence Delirium; Postoperative Complications
Study type: Interventional

Summary: 
      Postoperative delirium is with increased incidence in elderly patients. Previous studies have
      shown that acupuncture related techniques could induce protection against brain ischemia and
      improve outcome after cerebral diseases. In this study the effect of transcutaneous
      electrical acupoint stimulation combined with auricular acupressure on postoperative delirium
      will be evaluated.
    

Detailed description: 
      Postoperative delirium (POD) is an acute neurological disorder that commonly happens between
      postoperative days 1 and 3 and more common reported in elderly patients. The rate of delirium
      differs depending on the patients' characteristics, surgery types and setting of health care.
      The prevalence of delirium range from 18% to 35 % in a general medical service, and up to
      half of older patients postoperatively. It has been documented that POD is associated with an
      increase in mortality and morbidity, increased use of hospital resources, and higher cost of
      health care. The conventional preventive methods for delirium have focused on minimization or
      elimination of the predisposing and precipitating factors. Yet, few effective therapies are
      available for treating POD. New treatments are needed to reduce the prevalence and severity
      of delirium.

      Complementary therapies, particularly acupuncture, have gained increasing attention for their
      possible value in the prevention and treatment of neurological disorders. Both basic and
      clinical studies have suggested that acupuncture may be beneficial to postoperative delirium.
      In functional MRI studies of healthy subjects and nervous system dysfunction patients,
      acupuncture has been shown to stimulate hippocampus, amygdala and insula, areas of the brain
      associated with memory, cognition and emotion.

      In the clinical, TEAS has been reported to be effective in alleviating delirium in elderly
      patients with silent lacunar infarction. Evidence also showed that auricular acupunctures are
      efficacious for preventing postoperative agitation in geriatric patients

      Given evidences of the possible efficacy of TEAS and auricular acupressure, we aim to do a
      2-arm, randomized, controlled, single-blinded, pragmatic trial to investigate whether
      transcutaneous electrical acupoint stimulation combined with auricular acupressure is more
      effective in reducing postoperative delirium in elderly patients than usual care.
    

Intervention name(s): Transcutaneous acupoint electrical acupoint stimulation(TEAS) and auricular acupressure; Usual care
Intervention type(s): Device; Other
Intervention description(s): Bilaterally Hegu (LI4), Neiguan (PC6) and Zusanli (ST36) will be used as the TEAS acupoints. Six acupoints (Shenmen, Point Zero, subcortex, heart, liver, and endocrine) located on ears will be used as the auricular acupressure points.; Patients in this group only receive usual care developed by the study hospital
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Care Provider, Outcomes Assessor)
Primary purpose: Prevention
Keywords: Delirium; Elderly patients; Transcutaneous acupoint electrical acupoint stimulation; Auricular acupressure