J Neurogastroenterol Motil 2019; 25(2): 286-299  
Ameliorating Effects of Electroacupuncture on Dysmotility, Inflammation, and Pain Mediated via the Autonomic Mechanism in a Rat Model of Postoperative Ileus
Haruaki Murakami,1,2,3 Shiying Li,1 Robert Foreman,2 Jieyun Yin,1,4 Toshihiro Hirai,3 and Jiande D Z Chen1,4*
1Veterans Research and Education Foundation, Oklahoma City VA Medical Center, Oklahoma City, OK, USA; 2Department of Physiology, University of Oklahoma, Oklahoma City, OK, USA; 3Department of Digestive Surgery, Kawasaki Medical School, Okayama, Japan; and 4Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA
Correspondence to: Jiande D Z Chen, PhD
Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, USA, Tel: +1-410-550-6853, Fax: +1-405-456-3551, E-mail: jchen184@jhmi.edu
Received: May 23, 2018; Revised: September 26, 2018; Accepted: November 27, 2018; Published online: April 30, 2019.
© The Korean Society of Neurogastroenterology and Motility. All rights reserved.

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Background/Aims: Postoperative ileus increases healthcare costs and reduces the postoperative quality of life (QOL). The aim of this study is to investigate effects and mechanisms of electroacupuncture (EA) at ST36 and PC6 on gastrointestinal motility in rat model of postoperative ileus.
Methods: Laparotomy was performed in 24 rats (control [n = 8], sham-EA [n = 8], and EA [n = 8]) for the implantation of electrodes in the stomach and mid-jejunum for recording of gastric and small intestinal slow waves. Electrodes were placed in the chest skin for electrocardiogram (ECG). Intestinal manipulation (IM) was performed in Sham-EA and EA rats after surgical procedures. Small intestinal transit (SIT), gastric emptying (GE), postoperative pain, and plasma TNF-α were evaluated in all rats.
Results: (1) Compared with sham-EA, EA accelerated both SIT (P < 0.05) and GE (P < 0.05) and improved regularity of small intestinal slow waves. (2) Compared with the control rats (no IM), IM suppressed vagal activity and increased sympathovagal ratio assessed by the spectral analysis of heart rate variability from ECG, which were significantly prevented by EA. (3) EA significantly reduced pain score at 120 minutes (P < 0.05, vs 15 minutes) after the surgery, which was not seen with sham-EA. (4) Plasma TNF-α was increased by IM (P = 0.02) but suppressed by EA (P = 0.04) but not sham-EA.
Conclusion: The postoperative ileus induced by IM, EA at ST36 and PC6 exerts a prokinetic effect on SIT and GE, a regulatory effect on small intestinal slow waves and an analgesic effect on postoperative pain possibly mediated via the autonomic-cytokine mechanisms.
Keywords: Dysmotility; Electroacupuncture; Ileus; Inflammation; Pain

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