Electrical stimulation alleviates anxiety in patients undergoing laparoscopic resection

For patients undergoing laparoscopic resection for colorectal cancer (CRC), two sessions of transcranial direct current stimulation (tDCS) help reduce perioperative anxiety, as reported in a study.

A total of 196 adult patients with CRC (mean age 63.5 years, 63.3 percent men) who were scheduled to undergo laparoscopic radical resection were included in the study. These patients were randomly assigned to receive two sessions of either active (n=98) or sham (n=98) tDCS, delivered over the left dorsolateral prefrontal cortex on the afternoon of the day before the operation and in the morning of the day of operation.

The primary outcome of perioperative anxiety from the day of the operation up to 3 days after the procedure was measured using the Hospital Anxiety and Depression Scale-Anxiety (HADS-A) subscale, with higher scores indicating greater anxiety. Secondary outcomes included postoperative delirium (Confusion Assessment Method or Confusion Assessment Method intensive care unit scale), pain (10-point Numeric Rating Scale [NRS], with 0 indicating no pain and 10 indicating worst pain), frailty (Fatigue, Resistance, Ambulation, Illness and Loss of Weight [FRAIL] Index, with 0 indicating most robust and 5 indicating most frail), and sleep quality (Pittsburgh Sleep Quality Index [PSQI], with higher scores indicating worse sleep quality).

Perioperative anxiety occurred in 38.8 percent of patients in the active tDCS group and in 70.4 percent in the sham group. Active tDCS reduced the risk of incident perioperative anxiety by 45 percent (relative risk, 0.55, 95 percent confidence interval, 0.42–0.73; p<0.001).

Results for the secondary outcomes also favoured the active tDCS group, with lower incidence of postoperative delirium (8.2 percent vs 25.5 percent), lower median pain scores (NRS, 1.0 vs 2.0), better median sleep quality scores (PSQI, 10.5 vs 12.0), and lower median FRAIL Index (2.0 vs 2.0).

The present data underscore the potential of tDCS for improving perioperative anxiety in patients undergoing surgery.