TEAS for Sedation During ERCP: A Multicenter Trial
Transcutaneous Electrical Acupoint Stimulation Combined With Traditional Conscious Sedation for Endoscopic Retrograde Cholangiopancreatography: A Prospective, Randomized, Sham-Controlled, Multicenter Trial
Beijing 302 Hospital
130 participants
Jan 1, 2025
INTERVENTIONAL
Conditions
Summary
1. The goal of this clinical trial is to learn if transcutaneous electrical acupoint stimulation (TEAS), a non-invasive therapy that applies mild electrical current to specific points on the skin, can help patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) better tolerate the procedure and experience fewer complications related to sedation. It will also test whether TEAS improves procedural success and patient satisfaction. 2. The main questions the study aims to answer are: (1)Does TEAS reduce the incidence of sedation-related adverse events (such as low blood oxygen, low blood pressure, or breathing problems) during ERCP? (2)Does TEAS improve patient comfort and reduce the need for additional sedative medications during the procedure? (3)Does TEAS lead to faster recovery and higher patient and physician satisfaction? 3.Researchers will compare two approaches: 1. Active TEAS: Electrical stimulation at specific points on the legs and arms before and during ERCP. 2. Sham TEAS: Pads placed on the same points but no electrical stimulation delivered (the device appears active). 4.All participants will receive standard conscious sedation with meperidine and diazepam, which is commonly used for ERCP in many centers. Participants will be randomly assigned to one of the two groups. The study will measure sedation-related complications, pain levels, medication requirements, recovery times, and satisfaction scores.
Eligibility
Inclusion Criteria4
- Patients aged 18-80 years scheduled for elective diagnostic or therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for pancreaticobiliary indications.
- American Society of Anesthesiologists (ASA) physical status classification I, II, or III.
- Body mass index (BMI) between 18 and 30 kg/m².
- Willing and able to provide written informed consent.
Exclusion Criteria19
- Known allergy or contraindication to meperidine, diazepam, or any other medication used in the protocol.
- Chronic use of benzodiazepines or opioids (regular use more than three times per week in the preceding three months).
- Severe cardiopulmonary, hepatic, or renal dysfunction (e.g., New York Heart Association class III or IV heart failure, uncontrolled chronic obstructive pulmonary disease, estimated glomerular filtration rate \<30 mL/min/1.73m², active liver disease).
- Anticipated difficult airway (Mallampati score IV, mouth opening \<3 cm, thyromental distance \<6 cm).
- Untreated or severe obstructive sleep apnea requiring continuous positive airway pressure therapy.
- Pregnancy or breastfeeding.
- Psychiatric or cognitive disorders precluding cooperation or valid assessment (e.g., severe anxiety, cognitive impairment).
- Pre-induction resting heart rate \<50 beats per minute or second-degree or higher atrioventricular block.
- Conditions predisposing to aspiration (e.g., gastric outlet obstruction, previous esophageal or gastric surgery with delayed emptying).
- Previous exposure to transcutaneous electrical acupoint stimulation or knowledge of TEAS that could compromise blinding for the sham procedure.
- Skin lesions, infections, or electronic implants at or near the proposed acupoint locations.
- Inability to provide informed consent.
- \. Dropout Criteria:
- Requirement for conversion to general anesthesia due to failed sedation or clinical necessity.
- Occurrence of a serious adverse event related to the study intervention (e.g., severe allergic reaction, hemodynamic collapse).
- Life-threatening deterioration during endoscopy (e.g., uncontrolled bleeding, respiratory failure, cardiac arrest).
- Voluntary withdrawal of consent by participant or legal representative at any time.
- Occurrence of a major ERCP-related complication (e.g., perforation, major bleeding, severe pancreatitis) requiring surgical or intensive care intervention.
- Principal investigator-identified safety risks (e.g., sepsis, acute liver failure).
Interested in this trial?
Get notified about updates and connect with the research team.
Interventions
Participants receive real Transcutaneous Electrical Acupoint Stimulation (TEAS) delivered via surface electrodes bilaterally at four predefined acupoints: Yinlingquan (SP9), Yanglingquan (GB34), Xuehai (SP10), and Neiguan (PC6). Stimulation (dense-disperse wave, 2/20 Hz alternating frequency, intensity 2-5 mA adjusted to patient tolerance) begins 30 minutes before ERCP and continues throughout the procedure. All participants receive standardized conscious sedation with intravenous meperidine (0.5 mg/kg) and diazepam (0.1 mg/kg) administered by a blinded anesthesiologist.
Participants receive sham TEAS. Electrodes are placed identically to the Active TEAS Group at the same four acupoints (SP9, GB34, SP10, PC6) using the same device, but no electrical current is delivered. The device appears active (indicator lights on) to maintain blinding. All participants are informed that they may or may not feel any sensation, which is normal. All participants receive identical standardized conscious sedation with intravenous meperidine (0.5 mg/kg) and diazepam (0.1 mg/kg) administered by a blinded anesthesiologist.
Locations(1)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT07440342