{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T06:17:13Z","timestamp":1794032233599,"version":"4.8.0"},"reference-count":42,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Sichuan Science and Technology Program","award":["2021YFS0254"],"award-info":[{"award-number":["2021YFS0254"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,10,10]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Abdominal surgery is associated with common complications, including decreased or poor appetite, abdominal distension, abdominal pain caused by decreased or absent gastrointestinal motility, anal arrest with flatus and defecation, and nausea and vomiting resulting from the use of anaesthetics and opioid analgesics. These complications seriously affect postoperative recovery, prolong hospital stay and aggravate patient burden. This study aims to investigate for the first time the efficacy of transcutaneous electrical acupoint stimulation (TEAS) combined with electroacupuncture (EA) therapy for rapid recovery after laparotomy for gastrointestinal surgery. There have been no clinical studies of this combination therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This will be a prospective, single-centre, three-arm, randomised controlled trial. A total of 480 patients undergoing abdominal surgery will be stratified according to surgery type (ie, gastric or colorectal procedure) and randomised into three groups; namely, the EA, TEAS +EA and control groups. The control group will receive enhanced recovery after surgery (ERAS)-standardised perioperative management, including preoperative education, optimising the anaesthesia scheme, avoiding intraoperative hypothermia, restrictive fluid infusion and reducing surgical trauma. The EA group will receive EA stimulation at LI4, PC6, ST36, ST37 and ST39 based on the ERAS-standardised perioperative management. Moreover, the TEAS +EA group will receive ERAS-standardised perioperative management; EA stimulation at the LI4, PC6, ST36, ST37 and ST39; and TEAS stimulation at ST21 and SP15. The primary outcome will be the GI-2 (composite outcome of time to first defaecation and time to tolerance of a solid diet). Secondary outcomes will include the time of first passage of flatus, time to first defaecation, time to tolerance of a solid diet, time to first ambulation, hospital duration from operation to discharge, pain and nausea vomiting scores on the Visual Analogue Scale, medication use, incidence of postoperative complications and evaluation of treatment modality acceptability. All statistical analyses will be performed based on the intention-to-treat principle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethics approval has been granted by the Ethics Committee on Biomedical Research, West China Hospital of Sichuan University (approval number: 2021; number 52). The results are expected to be published in peer-reviewed journals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ChiCTR2100045646.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-053309","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T15:37:05Z","timestamp":1635867425000},"page":"e053309","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Transcutaneous electrical acupoint stimulation combined with electroacupuncture for rapid recovery of patients after laparotomy for gastrointestinal surgery: a study protocol for a randomised controlled trial"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3525-2684","authenticated-orcid":false,"given":"Hao","family":"Li","sequence":"first","affiliation":[{"name":"Department of Integrated Traditional Chinese and Western Medicine, Sichuan University West China Hospital, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4035-2903","authenticated-orcid":false,"given":"Qian","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Integrated Traditional Chinese and Western Medicine, Sichuan University West China Hospital, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3629-1420","authenticated-orcid":false,"given":"Lingyun","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Integrated Traditional Chinese and Western Medicine, Sichuan University West China Hospital, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hangqi","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Integrated Traditional Chinese and Western Medicine, Sichuan University West China Hospital, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"He","sequence":"additional","affiliation":[{"name":"Department of Integrated Traditional Chinese and Western Medicine, Sichuan University West China Hospital, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaming","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Sichuan University West China Hospital, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3996-868X","authenticated-orcid":false,"given":"Xiaoting","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Sichuan University West China Hospital, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9632-3944","authenticated-orcid":false,"given":"Ning","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Integrated Traditional Chinese and Western Medicine, Sichuan University West China Hospital, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,11,2]]},"reference":[{"key":"2025121223283435000_11.11.e053309.1","doi-asserted-by":"publisher","DOI":"10.4061\/2011\/269468"},{"key":"2025121223283435000_11.11.e053309.2","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1213\/ANE.0000000000004833","article-title":"Fourth consensus guidelines for the management of postoperative nausea and vomiting","volume":"131","author":"Gan","year":"2020","journal-title":"Anesth Analg"},{"key":"2025121223283435000_11.11.e053309.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2015.01.016"},{"key":"2025121223283435000_11.11.e053309.4","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.ijsu.2018.04.060","article-title":"Early enforced mobilization after liver resection: a prospective randomized controlled trial","volume":"54","author":"Ni","year":"2018","journal-title":"Int J Surg"},{"key":"2025121223283435000_11.11.e053309.5","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000020062","article-title":"Effect of enhanced recovery after surgery program on patient-reported outcomes and function recovery in patients undergoing liver resection for hepatocellular carcinoma","volume":"99","author":"Ren","year":"2020","journal-title":"Medicine"},{"key":"2025121223283435000_11.11.e053309.6","doi-asserted-by":"crossref","first-page":"3949","DOI":"10.1007\/s00464-019-07166-2","article-title":"Enhanced value with implementation of an eras protocol for ventral hernia repair","volume":"34","author":"Harryman","year":"2020","journal-title":"Surg Endosc"},{"key":"2025121223283435000_11.11.e053309.7","doi-asserted-by":"crossref","first-page":"S976","DOI":"10.21037\/jtd.2019.04.08","article-title":"Eras and patient reported outcomes in thoracic surgery: a review of current data","volume":"11","author":"Medbery","year":"2019","journal-title":"J Thorac Dis"},{"key":"2025121223283435000_11.11.e053309.8","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-019-04499-0"},{"key":"2025121223283435000_11.11.e053309.9","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1001\/jamasurg.2016.4952","article-title":"Enhanced recovery after surgery: a review","volume":"152","author":"Ljungqvist","year":"2017","journal-title":"JAMA Surg"},{"key":"2025121223283435000_11.11.e053309.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7284.473"},{"key":"2025121223283435000_11.11.e053309.11","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001067"},{"key":"2025121223283435000_11.11.e053309.12","doi-asserted-by":"crossref","first-page":"3273","DOI":"10.1007\/s11695-020-04585-2","article-title":"Randomized controlled trial comparing the outcomes of enhanced recovery after surgery and standard recovery pathways in laparoscopic sleeve gastrectomy","volume":"30","author":"Prabhakaran","year":"2020","journal-title":"Obes Surg"},{"key":"2025121223283435000_11.11.e053309.13","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(03)01118-5"},{"key":"2025121223283435000_11.11.e053309.14","doi-asserted-by":"crossref","first-page":"8304","DOI":"10.3748\/wjg.v21.i27.8304","article-title":"Acupuncture and regulation of gastrointestinal function","volume":"21","author":"Li","year":"2015","journal-title":"World J Gastroenterol"},{"key":"2025121223283435000_11.11.e053309.15","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.10.050"},{"key":"2025121223283435000_11.11.e053309.16","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1111\/j.1525-1403.2010.00295.x","article-title":"Mechanism of acupuncture on neuromodulation in the Gut-A review","volume":"14","author":"Takahashi","year":"2011","journal-title":"Neuromodulation: Technology at the Neural Interface"},{"key":"2025121223283435000_11.11.e053309.17","doi-asserted-by":"publisher","DOI":"10.1023\/A:1021730314068"},{"key":"2025121223283435000_11.11.e053309.18","doi-asserted-by":"crossref","DOI":"10.1111\/nmo.13808","article-title":"Effects of electroacupuncture on the intestinal motility and local inflammation are modulated by acupoint selection and stimulation frequency in postoperative ileus mice","volume":"32","author":"Yang","year":"2020","journal-title":"Neurogastroenterol Motil"},{"key":"2025121223283435000_11.11.e053309.19","first-page":"161","article-title":"Clinical study of Acupoint catgut embedding in the treatment of chronic functional constipation","volume":"33","author":"Ma","year":"2015","journal-title":"Journal of Sichuan of Traditional Chinese Medicine"},{"key":"2025121223283435000_11.11.e053309.20","first-page":"1132","article-title":"Clinical observation of acupuncture plus flash cupping for gastroparesis in senile type 2 diabetes","volume":"37","author":"S","year":"2018","journal-title":"Shanghai J Acu-mox"},{"key":"2025121223283435000_11.11.e053309.21","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/403251"},{"key":"2025121223283435000_11.11.e053309.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.pneurobio.2008.05.004"},{"key":"2025121223283435000_11.11.e053309.23","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-017-13633-4","article-title":"Acupuncture analgesia involves modulation of pain-induced gamma oscillations and cortical network connectivity","volume":"7","author":"Hauck","year":"2017","journal-title":"Sci Rep"},{"key":"2025121223283435000_11.11.e053309.24","doi-asserted-by":"crossref","first-page":"483","DOI":"10.2147\/JPR.S152015","article-title":"Mast cell deficiency attenuates acupuncture analgesia for mechanical pain using c-kit gene mutant rats","volume":"11","author":"Cui","year":"2018","journal-title":"J Pain Res"},{"key":"2025121223283435000_11.11.e053309.25","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0150367","article-title":"The efficacy of acupuncture in post-operative pain management: a systematic review and meta-analysis","volume":"11","author":"Wu","year":"2016","journal-title":"PLoS One"},{"key":"2025121223283435000_11.11.e053309.26","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1089\/end.2018.0665","article-title":"A randomized, double-blind, sham-controlled study assessing electroacupuncture for the management of postoperative pain after percutaneous nephrolithotomy","volume":"33","author":"Capodice","year":"2019","journal-title":"J Endourol"},{"key":"2025121223283435000_11.11.e053309.27","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000138"},{"key":"2025121223283435000_11.11.e053309.28","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/ANA.0000000000000290","article-title":"Effects of acupuncture in anesthesia for craniotomy: a meta-analysis","volume":"29","author":"Asmussen","year":"2017","journal-title":"J Neurosurg Anesthesiol"},{"key":"2025121223283435000_11.11.e053309.29","doi-asserted-by":"crossref","DOI":"10.1007\/s11916-018-0690-8","article-title":"New advances in acute postoperative pain management","volume":"22","author":"Mitra","year":"2018","journal-title":"Curr Pain Headache Rep"},{"key":"2025121223283435000_11.11.e053309.30","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1007\/s40265-013-0110-7","article-title":"Update on the management of postoperative nausea and vomiting","volume":"73","author":"Kovac","year":"2013","journal-title":"Drugs"},{"key":"2025121223283435000_11.11.e053309.31","first-page":"Cd003281","article-title":"Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting","volume":"2015","author":"Lee","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121223283435000_11.11.e053309.32","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31820f819e"},{"key":"2025121223283435000_11.11.e053309.33","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000130355.91214.9E"},{"key":"2025121223283435000_11.11.e053309.34","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.ijsu.2019.08.034","article-title":"Electroacupuncture or transcutaneous electroacupuncture for postoperative ileus after abdominal surgery: a systematic review and meta-analysis","volume":"70","author":"Chen","year":"2019","journal-title":"Int J Surg"},{"key":"2025121223283435000_11.11.e053309.35","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1111\/1759-7714.13343","article-title":"Efficacy of transcutaneous electrical acupoint stimulation combined with general anesthesia for sedation and postoperative analgesia in minimally invasive lung cancer surgery: a randomized, double-blind, placebo-controlled trial","volume":"11","author":"Chen","year":"2020","journal-title":"Thorac Cancer"},{"key":"2025121223283435000_11.11.e053309.36","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/S0254-6272(16)30061-9","article-title":"Effect of electric acupoint stimulation on gastrointestinal hormonesand motility among geriatric postoperative patients with gastrointestinaltumors","volume":"36","author":"Hou","year":"2016","journal-title":"J Tradit Chin Med"},{"key":"2025121223283435000_11.11.e053309.37","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1097\/AJP.0000000000000400","article-title":"Perioperative transcutaneous electrical Acupoint stimulation for postoperative pain relief following laparoscopic surgery: a randomized controlled trial","volume":"33","author":"Sun","year":"2017","journal-title":"Clin J Pain"},{"key":"2025121223283435000_11.11.e053309.38","unstructured":"Committee CNSA, Committee CISM . National standard of the people\u2019s Republic of China \u201cNomenclature and Location of Acupuncture Points\u201d(GB \/ T 12346-2006. Beijing: China Standards Press, 2006."},{"key":"2025121223283435000_11.11.e053309.39","first-page":"679","article-title":"[The value of acupuncture-moxibustion in enhance recovery after surgery]","volume":"40","author":"Xin","year":"2020","journal-title":"Zhongguo Zhen Jiu"},{"key":"2025121223283435000_11.11.e053309.40","first-page":"725","article-title":"[Comparison of Clinical Effects of Electroacupuncture of Abdominal and Limb Acupoints in the Treatment of Acute Pancreatitis]","volume":"43","author":"Li","year":"2018","journal-title":"Zhen Ci Yan Jiu"},{"key":"2025121223283435000_11.11.e053309.41","doi-asserted-by":"publisher","DOI":"10.7326\/m15-3118"},{"key":"2025121223283435000_11.11.e053309.42","doi-asserted-by":"publisher","DOI":"10.1089\/acm.2008.0107"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-053309","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:28:46Z","timestamp":1765610926000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-053309"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":42,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11,2]]},"published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1136\/bmjopen-2021-053309"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-053309","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}