Acupoint electrical stimulation at neiguan and zusanli points on serum cytokines

Lumbar disc herniation (LDH) surgery is commonly associated with perioperative challenges and impacts patient recovery. Acupuncture and acupoint electrical stimulation have been proposed for their potential neuroprotective, analgesic, and stress-modulating effects. This study aimed to investigate the influence of transcutaneous acupoint electrical stimulation on patients who underwent posterior spinal approach surgery for LDH. Patients received transcutaneous electrical stimulation at the neiguan or zusanli acupoints under general anesthesia. Serum levels of neuroimmune cytokines (nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and neuropeptide Y (NPY)), stress response factors (cortisol, epinephrine, norepinephrine (NE), adrenocorticotropic hormone (ACTH), and vanillylmandelic acid), pain scores (measured via the visual analog scale (VAS) at 1, 3, 6, 12, and 24 hours post-operatively), and postoperative psychological state (assessed via the self-rating anxiety scale (SAS) and self-rating depression scale (SDS)) were compared between the 2 groups. Neiguan stimulation was associated with increased NPY levels and decreased BDNF and NGF levels. Zusanolial stimulation was associated with increased BDNF and NGF levels, as well as elevated cortisol levels. The neiguan group presented elevated NE and ACTH levels. Pain scores measured via the VAS differed significantly at various postoperative time points. The zusanli group presented higher SAS and SDS. The distinct effects of acupoint stimulation on neuroimmune modulation, stress response dynamics, and perioperative outcomes highlight potential avenues for personalized perioperative care and targeted interventions.