Effect of electroacupuncture on postoperative delirium in elderly patients undergoing laparoscopic radical prostatectomy: study protocol for a double-center randomized controlled trial

Background: Postoperative delirium (POD) is an acute disorder of attention and cognition, frequently observed as a complication in elderly individuals undergoing major surgery. Patients undergoing laparoscopic radical prostatectomy (LRP) are particularly vulnerable due to advanced age and comorbidities. Electroacupuncture (EA), as a non-pharmacological intervention, may attenuate neuroinflammation and cerebral injury, potentially reducing the risk of POD. This study aims to evaluate the efficacy of EA in reducing the incidence of POD among elderly patients undergoing LRP. Methods: This is a double-center, prospective, randomized, patient- and assessor-blinded, sham-controlled trial. A total of 212 eligible participants will be enrolled and allocated in a 1:1 ratio to either the EA group or the sham EA (SEA) group. Participants in the EA group will receive intervention at the acupoints Zusanli (ST36) and Baihui (GV20), initiated 30 min prior to anesthesia induction and maintained for 25-30 min. The primary outcome is the incidence of POD assessed using the 3D-CAM during the first three postoperative days. Secondary endpoints include the duration and severity of delirium, delirium subtypes, pain scores, opioid consumption, catheter-related bladder discomfort, adverse events, and plasma levels of neuroinflammatory biomarkers. Discussion: Currently, evidence regarding the efficacy of EA in preventing POD specifically in elderly patients undergoing LRP is limited. This randomized controlled trial is designed to address this research gap. If the hypothesis is confirmed, this study will provide evidence for a safe, non-pharmacological strategy to improve postoperative cognitive outcomes in this population. Clinical trial registration: https://www.chictr.org.cn/showproj.html?proj=240562, Identifier: ChiCTR2500097337.