Effects of Acupuncture Stimulation on Systemic Inflammation

Study Overview
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Brief Summary
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60 ASA physical status I or II patients, aged 18-75 years old , scheduled for elective video-assisted thoracoscopic lobectomy surgery,will be randomized into 2 groups,with 30 patients in each group: 1. control group and 2. treatment group. Patients in treatment group will receive transcutaneous electrical acupoint stimulation(TEAS) during the surgery and at 6h and 24h after surgery. Patients in the control group received only TIVA general anesthesia and sham electrical stimulation. Serum from patients of both groups will be collected at before surgery, 1h and 25h after surgery, respectively. Serum levels of TNF-alpha, IL-1 beta, CXCL8, IFN gamma and IL-4 at different time points will be measured and compared between the two groups.

Detailed Description
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60 ASA physical status I or II patients, aged 18-75 years old , scheduled for elective video-assisted thoracoscopic lobectomy surgery,will be randomized into 2 groups,with 30 patients in each group: 1. control group, who will receive total intravenous anesthesia(TIVA) and sham stimulation; and 2. treatment group, who will receive (TIVA) and transcutaneous electrical acupoint stimulation(TEAS). Since 30 min before induction of anesthesia, patients in treatment group will be stimulated at the 4 acupoints , Houxi、Zhigou、Neiguan and Hegu on both sides by Han's Acupoint Nerve Stimulator(HANS) until the end of the operation. At 6h and 24h after surgery, patients in treatment group will receive TEAS again, for 30 min each time.The frequency was 2/100Hz,the stimulate intensity was the maximum current that could be tolerated when the patients were awake.The control group received only TIVA general anesthesia and sham electrical stimulation.Serum from patients of both groups will be collected at before surgery, 1h and 25h after surgery, respectively and serum levels of TNF-alpha, IL-1 beta, CXCL8, IFN gamma and IL-4 at different time points will be measured. The primary outcome measures are serum TNF-alpha and IL-1 beta levels at 25h after surgery. The secondary outcome measures include serum levels of TNF-alpha, IL-1 beta, CXCL8, Th1/Th2 ratio (by calculating IFN gamma/IL-4) at 1h post surgery and serum levels of CXCL8, Th1/Th2 ratio at 25h post surgery.

Official Title
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Effects of Acupuncture Stimulation on Systemic Inflammation in Patients Undergoing Video-assisted Thoracoscopic Lobectomy Surgery

Conditions
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Nonsmall Cell Lung Cancer

Intervention / Treatment
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* Procedure: Acupuncture stimulation
* Procedure: Sham stimulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients diagnosed Non-Small Cell Lung Carcinoma (NSCLC) and will have elective video-assisted thoracoscopic lobectomy surgery ASA grade 1-2 BMI between 18 to 31 kg/m2 Exclusion Criteria: with a history of thoracic surgery Unwilling to receive transcutaneous electrical acupoint stimulation BMI ≥ 32 kg/m2 Infection or scars at the acupoints periphery nerve injury at the upper or lower limbs Severe liver, renal, brain or lung disease Drug abuse Patients who cannot coordinate with investigators, such as dysphasia，severe infectious disease and disturbance of consciousness Patients participating other trials

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Sham Comparator: Sham stimulation<br>Put the electrodes on SI3, SJ6, PC6 and LI4 without stimulation. | Procedure: Sham stimulation<br>* Put electrodes on SI3, SJ6, PC6 and LI4 without stimulation<br>|
| Experimental: Treatment: Acupuncture stimulation<br>Stimulate the SI3, SJ6, PC6 and LI4 since 30 minutes before anesthesia induction until the end of operation. Stimulate again at above acupoints at 6 and 24h after operation, for 30 minutes each time. The stimulation frequency is 2/100Hz. The stimulation current is two to three times of the lowest current that the patient can feel. | Procedure: Acupuncture stimulation<br>* Transcutaneous electrical acupoint stimulation on SI3, SJ6, PC6 and LI4<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| serum TNF-α level |  | at 25 hour after surgery | 
| serum IL-1β level |  | at 25 hour after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| serum TNF-α level |  | at 1 hour after surgery | 
| serum IL-1β level |  | at 1 hour after surgery | 
| serum CXCL8 level |  | at 1 hour after surgery | 
| serum CXCL8 level |  | at 25 hour after surgery | 
| serum Th1/Th2 ratio |  | at 1 hour after surgery | 
| serum Th1/Th2 ratio |  | at 25 hour after surgery |