Objective To investigate the effects of transcutaneous electrical acupoint stimulation (TEAS) combined with low-dose dexmedetomidine on postoperative delirium and recovery in patients with esophageal cancer.

Methods A total of 94 patients with radical resection for esophageal cancer were randomly divided into observation group and control group, with 47 cases in each group. In the control group, dexmedetomidine was continuously intravenously infused after surgery, while TEAS intervention in the observation group was applied on the basis of the control group. The Visual Analogue Scale (VAS), the Pittsburgh Sleep Quality Index (PSQI) score, activity of daily living (ADL) score, recovery of self-care ability, and incidence of delirium were compared between the two groups. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP) in both groups.

Results On the 1st, 3rd, and 7th days after surgery, the VAS scores in the observation group were significantly lower than those in the control group (P < 0.05). The ADL scores of patients in both groups decreased significantly after surgery compared with those before surgery, and the ADL score in the control group was significantly lower than that in the observation group (P < 0.05). The PSQI scores of patients in both groups decreased significantly after surgery compared with those before surgery, and the PSQI score in the observation group was significantly lower than that in the control group (P < 0.001). The total incidence of postoperative delirium in the observation group was 8.51%(4/47), which was significantly lower than 27.66%(13/47) in the control group (P=0.016). There were no significant differences in the incidence of delirium at 4 h, >4 to 12 h, and >12 to 24 h after surgery between the two groups (P>0.05). One day before surgery, there were no significant differences in the levels of GFAP and NSE between the two groups (P>0.05). On the 1st and 3rd days after surgery, the levels of GFAP and NSE in both groups were significantly different from those in the same group one day before surgery (P < 0.05). On the 3rd day after surgery, the levels of GFAP and NSE in both groups changed significantly compared with those in the same group on the 1st day after surgery (P < 0.05). The levels of GFAP and NSE on the 1st and 3rd days after surgery in the observation group were significantly lower than those in the control group (P < 0.05).

Conclusion TEAS combined with dexmedetomidine can effectively reduce the incidence of postoperative delirium and promote functional recovery in patients with esophageal cancer through multiple synergistic pathways, including alleviating postoperative pain, reducing inflammatory responses, regulating neurotransmitters, and improving sleep quality.