Effect of Transcutaneous Auricular Vagus Nerve Stimulation on Postoperative Delirium in Elderly

28 Apr 20266 min read0 viewsJournal Feed

GIST

Introduction Postoperative delirium (POD) is a common acute central nervous system syndrome in elderly patients following surgery. Due to pre-existing brain tissue damage, elderly patients with non-acute fragile brain function (NFBF) are at higher risk of developing POD, which can lead to long-term cognitive impairment, postoperative complications increasing and prolong hospitalisation.

Transcutaneous auricular vagus nerve stimulation (taVNS) has been demonstrated to play a significant role in treating various neurological disorders, including epilepsy, depression and consciousness impairment. However, its efficacy in preventing POD in elderly NFBF patients remains unknown.

Therefore, this study aims to investigate the effect of perioperative taVNS on the incidence of POD in elderly NFBF patients. Methods and analysis A bi-centre, double-blind, randomised, controlled trial will be conducted at Beijing Friendship Hospital, Capital Medical University and Xiyuan Hospital of China Academy of Traditional Chinese Medical Sciences, China, from December 2025 to December 2026.

Clinical Editorial

Study Objective and Context

The target population comprises adults aged 60 years and older undergoing abdominal surgery, with existing brain tissue vulnerability.

The article outlines a bi-center, double-blind, randomised, controlled protocol to assess whether perioperative transcutaneous auricular vagus nerve stimulation (taVNS) can influence the incidence of postoperative delirium (POD) in elderly patients with non-acute fragile brain function (NFBF).

Design and Settings

Design: randomised, controlled, double-blind, parallel-group trial.
Setting: two centers in China—Beijing Friendship Hospital, Capital Medical University, and Xiyuan Hospital of the China Academy of Traditional Chinese Medical Sciences.
Duration: recruitment and follow-up span from December 2025 to December 2026.
Randomization: participants will be allocated to two intervention arms in a 1:1 ratio.

Interventions and Comparators

Active intervention: taVNS, administering transcutaneous auricular stimulation intended to engage the auricular vagus nerve.
Control comparator: transcutaneous non-vagus nerve stimulation (tnVNS), serving as a sham-like stimulation to control for non-specific effects.
Perioperative window: stimulation is framed as perioperative, indicating administration around the time of surgery.

Population and Eligibility

Population: elderly patients (≥60 years) with NFBF undergoing abdominal surgery.
Inclusion criteria specifics are not detailed beyond age, NFBF status, and planned abdominal surgery in the provided content; comprehensive eligibility criteria are not reported in the source material.

Primary and Secondary Outcomes

Primary outcome: incidence of POD within 5 days after surgery.
Secondary outcomes (reported): delirium severity, changes in biomarkers, postoperative delayed cognitive dysfunction, Numerical Rating Scale (NRS) pain scores, recovery of gastrointestinal function, anesthesia-related parameters, economic indicators, and the incidence of perioperative complications or other serious adverse events.

Ethics, Registration, and Reporting

Ethics: study approvals were obtained from the Ethics Committee of Beijing Friendship Hospital, Capital Medical University, with adherence to the Declaration of Helsinki.
Protocol standards: prepared in alignment with the 2013 Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines.
Dissemination: results are planned for publication in a peer-reviewed journal and presentation at scientific meetings; trial registration number is ITMCTR2025002263.