Effect of press needle stimulation on postoperative pulmonary complications in video-assisted thoracoscopic surgery patients: a randomized controlled trial

Patients undergoing high-risk surgical procedures frequently experience postoperative pulmonary complications (PPCs) that impact outcomes. Acupuncture has demonstrated potential benefits during surgery. Press needle stimulation is increasingly recognized as an alternative to conventional techniques. We aimed to evaluate the effect of press needle stimulation on PPCs in patients with lung cancer undergoing video-assisted thoracoscopic surgery.
Eighty-seven patients undergoing video-assisted thoracoscopic surgery were randomized into press needle (n = 48) or sham needle (n = 39) groups. The press needle group underwent bilateral stimulation of acupoints LU9 (Taiyuan), RN17 (Danzhong), LU6 (Kongzui), and BL13 (Feishu) before anesthesia and during surgery. The sham group received a placebo stimulation. The primary endpoint was the incidence of PPCs within seven days post-surgery. The secondary endpoints included cytokine levels, intraoperative respiratory mechanics, postoperative pain score, analgesic consumption, and related complications.
Press needle acupoint stimulation was associated with a significantly lower incidence of PPCs than the sham needle group. Perioperative data, tachycardia, cough, postoperative nausea, vomiting, and most inflammatory markers exhibited no significant differences, except for lower hypoxia-inducible factor-1α levels in the press needle group. Hemodynamic and blood gas analyses indicated no significant cardiovascular or respiratory differences between groups. The press needle group exhibited reduced patient-controlled analgesia (PCA) pump utilization and lower total PCA usage, indicating improved pain management.
This study indicates that press needle stimulation lowers PPC incidence and improves postoperative analgesia in patients with lung cancer undergoing video-assisted thoracoscopic lobectomy.

Press needle stimulation is a feasible adjunct therapy for patients undergoing video-assisted thoracoscopic surgery.
Using press needle stimulation reduces postoperative pulmonary complications.
Press needle stimulation allows for improved pain control.
Press needle stimulation may be an effective intervention for improving patient outcomes.

Press needle stimulation is a feasible adjunct therapy for patients undergoing video-assisted thoracoscopic surgery.
Using press needle stimulation reduces postoperative pulmonary complications.
Press needle stimulation allows for improved pain control.
Press needle stimulation may be an effective intervention for improving patient outcomes.

接受高危外科手术的患者常出现术后肺部并发症（postoperative pulmonary complications, PPCs），对预后造成不良影响。针灸在手术期间已展现出潜在获益。按压式针刺激（press needle stimulation）正日益被认可为传统针刺技术的替代方案。本研究旨在评估按压式针刺激对肺癌患者接受电视辅助胸腔镜手术（video-assisted thoracoscopic surgery）时术后肺部并发症的影响。
本研究共纳入87例拟行胸腔镜手术的患者，按随机原则分为按压针刺激组（n=48）与假针刺激组（n=39）。按压针刺激组在麻醉诱导前及手术过程中接受双侧穴位LU9（太渊）、RN17（膻中）、LU6（孔最）及BL13（肺俞）刺激。假针刺激组则接受安慰剂对照刺激。主要终点为术后7天内术后肺部并发症的发生率。次要终点包括细胞因子水平、术中呼吸力学参数、术后疼痛评分、镇痛药物消耗量及相关并发症。
与假针刺激组相比，按压针刺激组的术后肺部并发症发生率显著降低。围手术期数据显示，除按压针刺激组的缺氧诱导因子-1α（hypoxia-inducible factor-1α）水平更低外，心动过速、咳嗽、术后恶心呕吐及大多数炎症标志物均无显著组间差异。血流动力学与血气分析结果显示，两组间心血管及呼吸指标无显著差异。按压针刺激组的患者自控镇痛（patient-controlled analgesia, PCA）泵使用率及总镇痛消耗量均更低，提示疼痛管理效果更佳。
本研究表明，按压式针刺激可降低肺癌患者接受胸腔镜肺叶切除术（video-assisted thoracoscopic lobectomy）时的术后肺部并发症发生率，并改善术后镇痛效果。
按压式针刺激是胸腔镜手术患者可行的辅助治疗手段。
按压式针刺激可降低术后肺部并发症发生率。
按压式针刺激可实现更优的疼痛控制。
按压式针刺激或为改善患者预后的有效干预措施。
按压式针刺激是胸腔镜手术患者可行的辅助治疗手段。
按压式针刺激可降低术后肺部并发症发生率。
按压式针刺激可实现更优的疼痛控制。
按压式针刺激或为改善患者预后的有效干预措施。