JMIR Publications

ABSTRACT

Background:

Perioperative neurocognitive disorder (PND) is a critical concern for elderly cardiac surgery patients, impacting cognitive function and quality of life. Electroacupuncture (EA) and Transcutaneous Electrical Acupoint Stimulation (TEAS) hold promise for mitigating PND. This protocol outlines a systematic review and meta-analysis to thoroughly assess EA/TEAS efficacy in elderly cardiac surgery patients with PND, informing up-to-date evidence for PND prevention and treatment.

Objective:

To thoroughly assess the efficacy of electroacupuncture and transcutaneous electrical acupoint stimulation on elderly cardiac surgery patients with perioperative neurocognitive disorder, informing up-to-date evidence for perioperative neurocognitive disorder prevention and treatment.

Methods:

A comprehensive and systematic approach will be employed to identify eligible studies from a diverse range of electronic databases, including nine major sources such as PubMed and Cochrane, as well as two clinical trial registration websites. These studies will focus on investigating the effects of EA/TEAS on PND in elderly patients undergoing cardiac surgery. The study selection will adhere to the criteria outlined in the PICOS format. Data extraction will be carried out by two independent researchers, utilizing established tools to evaluate the risk of bias. The primary outcome will be PND incidence, with secondary outcomes including Mini-Mental State Examination scores, neuron-specific enolase, S100β, interleukin-1β, interleukin-6, tumor necrosis factor-α, time to first flatus, first defecation, bowel sound recovery, and hospitalization duration to be selectively reported. Adverse events linked to acupuncture, such as bleeding, needle site pain, and local reactions, rather than serious adverse events, will also be considered. Meta-analysis will be performed using appropriate statistical methods to assess the overall effect of EA/TEAS on PND prevention, treatment, or other relevant outcomes. the Cochrane Collaboration Risk of Bias (ROB) tool will be utilized for assessment, and data synthesis will be executed using the RevMan 5.4 software.

Results:

We plan to summarize the eligible studies through the utilization of a PRISMA flowchart. The findings will be showcased in the form of a summary table of evidence. Figures and forest plots will be employed to illustrate the outcomes of the meta-analysis.

Conclusions:

The impact of electroacupuncture and transcutaneous acupoint electrical stimulation interventions on Perioperative neurocognitive disorder in elderly cardiac surgery patients has not yet been established. This protocol addresses a critical gap by thoroughly assessing EA and TEAS for PND in elderly cardiac surgery patients, enhancing understanding of non-pharmacological interventions and guiding future research and clinical practices in this field. Its strength lies in rigorous methodology, including comprehensive search strategies, independent review processes, and thorough assessments of the risk of bias. Clinical Trial: PROSPERO registration number: CRD42023411927.