Intraoperative Vagus Nerve Stimulation Accelerates Postoperative Recovery in Rats
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Postoperative ileus (POI) is a heavy burden for healthcare industries and reduces the postoperative quality of life. The aim of this study was to investigate the effects and mechanisms of the intraoperative vagus nerve stimulation (iVNS) on gastrointestinal motility in a rodent model of POI.
For control group (control, n = 8), electrodes were placed on the chest wall for recording the electrocardiogram and on the stomach and small intestine for measuring gastric slow waves (GSWs) and small intestinal slow waves (SSWs). For sham group (sham, n = 8) and iVNS group (VNS, n = 8), after the same surgery as the control, intestinal manipulation (IM) was performed to induce POI. iVNS was performed during the surgery for the iVNS group. Small intestinal transit (SIT), gastric emptying (GE), postoperative pain, and plasma TNF-α were evaluated after operation.
IM delayed GE that was normalized by iVNS (P < 0.05). iVNS reduced plasma TNF-α increased by IM (P = 0.04). iVNS prevents the injury of ileum mucosa induced by IM (P < 0.05). iVNS reduced the postoperative pain (P < 0.05). iVNS prevented the IM-induced decrease in vagal activity (sham 0–30 min vs. 150–180 min, P = 0.03, VNS 0–30 min vs. 150–180 min, P = 0.58) and increase in sympathovagal balance (sham 0–30 min vs. 150–180 min, P = 0.04, VNS 0–30 min vs. 150–180 min, P = 0.72).
iVNS accelerates postoperative recovery by improving GE, reducing postoperative pain, and preventing the injury of ileum mucosa mediated via the autonomic mechanisms.
KeywordsIntraoperative vagus nerve stimulation Postoperative recovery Postoperative ileus Motility Pain Inflammation
Haruaki Murakami, Shiying Li, and Jieyun Yin, performed the research; Jiande DZ Chen, Robert Foreman, and Toshihiro Hirai designed the research study; Haruaki Murakami, Shiying Li, Robert Foreman, Jieyun Yin, and Jiande DZ Chen analyzed the data; Haruaki Murakami wrote the paper; and Haruaki Murakami, Shiying Li, Robert Foreman, Jieyun Yin, Toshihiro Hirai, and Jiande DZ Chen approved the final version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
This work was partially financially supported by a grant from Veterans Research and Education Foundation, VA Medical Center, Oklahoma City, OK.
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