The Effect of taVNS on the Prognosis of Patients Undergoing Pancreatoduodenectomy

The Effect of Transcutaneous Auricular Vagus Nerve Stimulation on the Incidence of Delayed Gastric Emptying After Pancreatoduodenectomy: A Randomized Controlled Trial

To explore the effects of transcutaneous auricular vagus nerve stimulation (taVNS) during the perioperative period on the incidence of delayed gastric emptying after pancreatoduodenectomy and its possible mechanisms.

Patients are recruited one week prior to the start of the trial, during which they are informed about the experimental protocol and associated risks. After obtaining informed consent and signatures, they are enrolled as study participants. Patients who meet the trial criteria are randomly assigned in a 1:1 ratio to the control group (sham taVNS group) and the intervention group (taVNS group, with taVNS intervention starting 30 minutes prior to anesthesia induction and continuing until the end of surgery, terminating after the removal of the endotracheal tube in the PACU), in a double-blind manner (with taVNS intervention and postoperative follow-up conducted by different researchers).

Inclusion Criteria:

• Age ≥18 years;
• Diagnosed with pancreatic tumors or periampullary tumors by imaging or pathology and scheduled for pancreaticoduodenectomy;
• No distant metastases and tumors are resectable;
• Classified as American Society of Anesthesiologists (ASA) physical status I to III;
• Capable of understanding the study procedures and various assessment scales and able to effectively communicate with the researchers;
• Willing to participate in the study and provide written informed consent.

Exclusion Criteria:

• Patients with other malignant tumors;
• Patients who have undergone chemotherapy or radiotherapy before surgery;
• Patients with chronic organ dysfunction;
• Patients with a history of gastrectomy or other gastric surgeries;
• Patients diagnosed with chronic gastrointestinal inflammation, peptic ulcers, or a history of gastroparesis, pyloric, or other gastrointestinal obstructions;
• Patients with a history of autonomic dysfunction (e.g., peripheral neuropathy, vagotomy, thyroid dysfunction, amyloidosis, asthma, heart failure, renal dysfunction, or alcoholism);
• Patients with implanted stimulators (e.g., pacemakers, implanted vagus nerve stimulators, deep brain stimulators, spinal cord stimulators), cochlear implants, or metallic implants (excluding dental work);
• Patients who recently used prokinetic agents, cholinergic or anticholinergic drugs, or hormones;
• Patients who received vagus nerve stimulation or acupuncture within 1 month before the study;
• Patients with skin damage or dermatological conditions at the stimulation site;
• Patients with a preoperative heart rate below 60 beats per minute;
• Patients unable to cooperate with assessments;
• Patients participating in other clinical trials.