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Objective:To evaluate the effect of electroacupuncture preconditioning on the immune function of elderly patients after radical resection for gastric cancer.Methods:A total of 70 patients, aged 65 to 75 yr, with body mass index of 18-25 kg/m 2, scheduled for elective radical resection for gastric cancer, of American Society of Anesthesiology physical status Ⅱ or Ⅲ, were divided into 2 groups ( n=35 each) by a random number table method: electroacupuncture pretreatment group (group EP) and control group (group C). Combined intravenous-inhalational anesthesia was used in both groups.In group EP, electroacupuncture (continuous wave, frequency 2/100Hz, current 1 mA) of the internal anesthesia point and Zusanli acupoint was performed for 30 min before induction of anesthesia.In group C, electroacupuncture was not performed, and patient-controlled intravenous analgesia was used after operation.Before electroacupuncture and at 2, 12, 24 and 48 h after operation (T 0-4), the rating of safety and efficacy was assessed, and central venous blood samples were collected, and the percentages of CD3 + , CD4 + and CD8 + T cells were measured by flow cytometry, and the CD4 + /CD8 + ratio was calculated. Results:There was no significant difference in the rating of safety and efficacy between the two groups ( P>0.05). Compared with the baseline at T 0, the percentages of serum CD3 + and CD4 + T cells and CD4 + /CD8 + ratio at T 1-4 and percentage of CD8 + T cells at T 3 were significantly decreased in group C ( P<0.05). Compared with group C, the percentages of serum CD 3+ and CD4 + T cells and CD4 + /CD8 + ratio at T 1-4 and percentage of CD8 + T cells at T 3 were significantly increased in group EP ( P<0.05). Conclusion:Electroacupuncture of internal anesthesia points and Zusanli acupoint preconditioning can improve the immune function of elderly patients after radical resection for gastric cancer.
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OBJECTIVE@#To investigate the change trend and correlation between the perioperative pain degree and neuroendocrine hormone levels in the perioperative period on patients with thyroid surgery by electroacupuncture combined with cervical plexus block.@*METHODS@#Forty patients with elective thyroidectomy were enrolled and divided into a control group and an observation group according to the random number table method, 20 cases in each group. In the control group, cervical plexus block was performed. In the observation group, the cervical plexus block combined with electroacupuncture (EA) were given. After the cervical plexus block was completed, the EA was applied at the bilateral Hegu (LI 4) and Neiguan (PC 6) for 30 min. The visual analog scale (VAS) was used to assess the pain level before anesthesia (T), 2 h after operation (T), 12 h after operation (T), 24 h after operation (T) and 48 h after operation (T). Blood samples such as adrenocorticotropic hormone (ACTH), C-reactive protein (CRP) and β-endorphin (β-EP) were collected to measure the level of neuroendocrine hormones, and to analyze the correlation between ACTH, CRP, β-EP and VAS scores.@*RESULTS@#The VAS scores at T, T, T were higher than those at T in the two groups (all <0.05). The VAS scores T, T and T in the observation group were lower than those in the control group (all <0.05). The ACTH and CRP in the control group at T, T and T were significantly higher than those at T (all <0.05). The β-EP in the observation group at T, T and T was significantly higher than that at T (all <0.05). The ACTH and CRP in the observation group at T, T and T were lower than those in the control group,and the β-EP level was higher than that in the control group (all <0.05).The VAS score was significantly positively correlated with ACTH and CRP levels, and negatively correlated with β-EP.@*CONCLUSION@#EA stimulation can inhibit the secretion of ACTH and CRP, promote the release of β-EP, reduce the perioperative pain score, and inhibit the body's stress response.
Subject(s)
Humans , Cervical Plexus Block , Electroacupuncture , Pain Management , Thyroid Gland , General Surgery , beta-EndorphinABSTRACT
<p><b>OBJECTIVE</b>To discuss the clinical therapeutic effects of electroacupuncture at Neimadian (Extra) and Neiguan (PC 6) on the analgesic effect of thoracic perioperative stage and its effect mechanism.</p><p><b>METHODS</b>Sixty cases of esophageal cancer with elective radical resection under general anesthesia were divided into an observation group and a control group according to the operation sequence, 30 cases in each one. In the control group, the general anesthesia was simply applied and sufentanil was administered for patient controlled intravenous analgesia (PCIA) after operation. In the observation group, on the basis of the scheme as the control group, the electroacupuncture was used at Neimadian (Extra) and Neiguan (PC 6) 30 min before anesthesia induction and after operation, with continuous wave, tolerable intensity, lasting for 30 min. Separately, before acupuncture (T1) and 2h (T2), 12h (T3), 24h (T4) and 48h (T5) after operation, the plasma β-endorphin (β-EP), 5-hydroxytryptamine (5-HT) and prostaglandin E(PGE) were determined. During operation, under the same state (from 50 to 60) of bispectrum of EEG (BIS), the intraoperative anesthetic dose was recorded. Using visual analogue scale (VAS), the pain degree was evaluated at T2, T3, T4 and T5 separately and the grade assessment of the therapeutic effects and safety were recorded at each time point.</p><p><b>RESULTS</b>①The total dosage of sufentanil in the observation group was less than that in the control group[(1.83±0.56) mg vs (2.54±0.62) mg,<0.05]. ②VAS scores at T2, T3 and T4 in the patients of the observation group were all lower than those in the control group (all<0.05). ③The levels of plasma β-EP at T3, T4 and T5 in the observation group were increased significantly as compared with those in the control group (all<0.05) and the levels of plasma 5-HT and PGEat T2, T3 and T4 were reduced significantly as compared with those in the control group (all<0.05). ④ The excellent analgesia rates 2h、12h and 24h after operation in the observation group were better than those in the control group (all<0.05). ⑤The rate of the A grade safety in the observation group was higher than that in the control group (<0.05).</p><p><b>CONCLUSIONS</b>Electroacupuncture at Neimadian (Extra) and Neiguan (PC 6) provides the safe and effective postoperative anesthesia of thoracic surgery and reduces the dosage of analgesics during the operation, which is possibly related to the increase of endogenous β-EP and the inhibition on the release of 5-HT and PGE.</p>