RESUMO
BACKGROUND: To observe the effects of conventional theatre nursing combined with transcutaneous electrical acupoint stimulation (TEAS) on postoperative cognitive dysfunction (POCD) in elderly total knee arthroplasty (TKA) patients. METHODS: Forty elderly TKA patients were randomly divided into a conventional nursing (control) group and a TEAS group. Using conventional nursing, TEAS was used to stimulate the "Zusanli" and "Sanyinjiao" in the healthy leg of patients in the TEAS group. All patients received mini-mental (MMSE) scores 1 day before surgery (T0) and 1, 3, and 7 days after surgery (T1, T3, T7). Plasma levels of interleukin-1 (IL-1ß), interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and S100ß were measured using venous blood samples. RESULTS: There were no significant differences in baseline clinical characteristics between the two groups. Compared to T0, the MMSE scores of patients in the control group were significantly reduced at T1 and T3 (P < 0.05). Compared to the control group, the MMSE scores of patients in the TEAS group increased significantly at T3 (P < 0.05). The incidence of POCD in the TEAS group was 10%, lower than in the control group (40%) (P < 0.05). The levels of IL-1ß, IL-6, TNF-α and S-100ß in patients in the TEAS group were lower than in the control group on days T1, T3 and T7 (P < 0.05). CONCLUSION: Conventional intraoperative nursing combined with TEAS can reduce the incidence of POCD. The possible mechanism is related to the reduction of inflammatory response and neuronal injury with TEAS. CLINICAL REGISTRATION NUMBER: ChiCTR2300070281.