Effect of assisted anesthesia of auricular point magnetic sticking on postoperative recovery of gynecological surgery / 中国针灸

<p><b>OBJECTIVE</b>To explore an optimum method on postoperative recovery of general-anesthesia gynecological laparoscopic surgery.</p><p><b>METHODS</b>One hundred and twenty cases of gynecological laparoscopic surgery were randomly divided into three groups, 40 cases in each one. The sensitive points of bilateral Shenmen (TF4), Zigong (TF2), Wei (CO4), Dachang (CO7) and so on were selected in all three groups one night before the surgery. The sticking with magnetic beads was applied in the group A. The magnetic beads were in-pair stuck at front-back corresponding location of both ears in the group B. The same-appearance plaster was put at the corresponding acupoints in the group C. The intubation anesthesia was applied in all three groups and postoperative recovery of gynecological laparoscopic surgery was observed.</p><p><b>RESULTS</b>The postoperative visual analogue scale (VAS) was (1.77 +/- 1.65) in the group A and (1.80 +/- 1.96) in the group B, which was both lower than (2.62 +/- 1.46) in the group C (both P < 0.01). The occurrence rate of nausea and vomiting was 25.0% (9/36) in the group A and 20.0% (8/40) in the group B, which was both lower than 50.0% (19/38) in the group C (both P < 0.01). The recovery of borborygmus on postoperative 1st and 3rd day in the group A and B was faster than that in the group C (both P < 0.05), while time of fart and defecation in the group A and B was earlier than that in the group C (both P < 0.05). The score of state-trait anxiety inventory in the group A and B was lower than that in the group C (both P < 0.05), but the differences of each item between the group A and B were not obvious (both P > 0.05).</p><p><b>CONCLUSION</b>The auricular point sticking could support analgesia of general-anesthesia gynecological laparoscopic surgery, which could relieve anxiety mood, reduce occurrence of nausea and vomiting and improve function of stomach and intestine to benefit postoperative recovery. However, the effect of in-pair sticking of auricular point with magnetic beads at front-back acupoints was not obviously strengthened.</p>

Effects of magnetic auricular point-sticking on adjuvant anesthesia and postoperative recovery of body function / 中国针灸

<p><b>OBJECTIVE</b>To prove analgesia and sedative effect of adjuvant anesthesia with magnetic auricular point-sticking on abdominal gynecological operation and its effect on postoperative recovery of body function.</p><p><b>METHODS</b>Ninety-two patients with abdominal gynecological operation were randomly divided into 3 groups. The auricular point-sticking group (APS group, n=31) was pasted and pressed by plasters with magnetic beads at bilateral Shenmen, Pizhixia (subcortex), Zigong (uterus) and Penqiang (pelvic cavity), etc. the night before operation. The placebo group (n=31) was pasted by plasters without magnetic beads. The blank group (n=30) was given no intervention. The mental and gastrointestinal functional changes before and 3 days after the operation were observed.</p><p><b>RESULTS</b>As compared with those in the control group and the blank group, the postoperative score of Self rating Anxiety Scale (SAS) was less (25.5 +/- 0.81 vs. 28.9 +/- 3.19, 28.3 +/- 2.36, both P < 0.01), with lower-dose of Innovar [(2.5 + 1.1) mL vs. (3.4 + 1.8) mL, (3.2 + 1.6) mL, both P < 0.05], earlier exsufflation after the operation [(34.2 + 12.1) h vs. (46.3 + 10.9) h, (43.2 + 14.8) h, both P < 0.01] and higher level serum of beta-endorphin before and after the operation in the APS group (all P < 0.05).</p><p><b>CONCLUSION</b>The magnetic auricular point-sticking has sedative, analgesic and function-regulating effects on the abdominal gynecological operation.</p>

Effects of electroacupuncture preconditioning at "Neiguan" (PC 6) on gene expression of myocardial opioid receptors in rats with myocardial ischemia-reperfusion injury / 中国针灸

<p><b>OBJECTIVE</b>To explore the protective effects of electroacupuncture preconditioning at "Neiguan" (PC 6) on myocardial ischemia reperfusion injury (MIRI) and the mechanism.</p><p><b>METHODS</b>Forty-eight male Wistar rats were randomly divided into a sham operation group (group N), a MIRI group (group M) and an electroacupuncture group (group E). The MIRI model was generated by ligating the left anterior descending artery (LAD) for 30 min followed by reperfusion for 120 min. The partition sutures in group N were passed under the LAD without ligation. The rats in group E were pretreated with electroacupuncture applied at bilateral "Neiguan" (PC 6) for 20 min once a day on 3 consecutive days before ischemia. The area at risk and infarct size and the serum levels of CK-MB and LDH were measured. The morphological changes were observed by light microscopy. The mRNA expressions of delta and kappa opioid receptor (DOR and KOR) were determined by real-time RT-PCR.</p><p><b>RESULTS</b>The myocardial infarct size in group E was significant smaller than that in group M (P < 0.05). The contents of CK-MB and LDH were (980 +/- 92) U/L and (2 743 +/- 124) U/L in group M which were significant higher than (312 +/- 41) U/L and (530 +/- 56) U/L in group N (both P < 0.01) and (572 +/- 70) U/L and (1 819 +/- 97) U/L in group E (both P < 0.01). The mRNA expressions of DOR and KOR had no significant difference between group M and N (both P > 0.05), while the DOR expression in group E was significant higher than that in group M and N (both P < 0.01). There was no significant difference in KOR expression among three groups (all P > 0.05).</p><p><b>CONCLUSION</b>The cardiac protective effects of electroacupuncture preconditioning at "Neiguan" (PC 6) on MIRI may be mediated by increasing expression of delta opioid receptor in myocardium.</p>

Effect of sevoflurane versus propofol-remifentanil anesthesia on neuromuscular blockade by continuous cisatracurium infusion / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the effects of sevoflurane and propofol-remifentanil anesthesia on neuromuscular blockade produced by continuous cisatracurium infusion.</p><p><b>METHODS</b>Forty ASA I or II patients undergoing selective surgery were randomly divided into sevoflurane and propofol-remifentanil anesthesia groups (n=20). Neuromuscular blockade was monitored using train-of-four (TOF) stimulation by recording the contraction force of the adductor pollicis muscle with a muscle relaxation monitor. A bolus dose of cisatracurium of 0.15 mg/kg was administered to facilitate endotracheal intubation, followed by continuous infusion adjusted manually to maintain the first twitch (T1) < or = 5% of the control level. The following variables were recorded including the infusion rate, total amount of cisatracurium, spontaneous recovery index (RI), and the time interval from termination of infusion cisatracurium to recovery of TOF ratio (TOFR) to 0.9.</p><p><b>RESULTS</b>With the maintenance of a 95%-99% neuromuscular blockade, the infusion rate was significantly lower in sevoflurane group than in propofol-remifentanil group (P<0.05), and stabilized in both groups after 120 min. No significant differences were found in RI or the time to TOFR of 0.9 between the two groups (P>0.05).</p><p><b>CONCLUSION</b>During the maintenance of stable neuromuscular blockade by continuous cisatracurium infusion, both sevoflurane and propofol-remifentanil anesthesia can time-dependently enhance the effect of cisatracurium without producing significant differences in the recovery properties.</p>

Effects of scalp acupuncture on regulative ability of oxidative stress reaction at operation stage / 中国针灸

<p><b>OBJECTIVE</b>To study on regulative action of scalp acupuncture on oxidative stress reaction at operation stage.</p><p><b>METHODS</b>Fifty two cases selected for radical operation of intestinal cancer were randomly divided into a scalp acupuncture plus general anesthesia (scalp acupuncture group) and a simple general anesthesia group (general anesthesia group), 26 cases in each group. The scalp acupuncture group were treated first with scalp acupuncture for 20 min, followed by general anesthesia, with scalp acupuncture lasted till the end of operation. The general anesthesia group were treated only with simple intratracheal anesthesia. Effects of scalp acupuncture on malondialdehyde (MDA) level and superoxide dismutase (SOD) activity at the operation stage were observed.</p><p><b>RESULTS</b>After operation, MDA levels decreased significantly (P < 0.05) in the two groups, but with no difference between the two groups in the different values of MDA before and after treatment (P > 0.05); there was no significant change in SOD before and after treatment in the scalp acupuncture group, and significantly decreased in the general anesthesia group (P < 0.05). There was a significant difference between the two groups in the different value of SOD before and after the operation (P < 0.05).</p><p><b>CONCLUSION</b>Scalp acupuncture can inhibit the decrease of SOD activity, reducing oxidative stress reaction at operation stage.</p>

Role of acupuncture anesthesia in operation of rectal cancer / 中国针灸

<p><b>OBJECTIVE</b>To observe analgesic effect of acupuncture anesthesia.</p><p><b>METHODS</b>Sixty-nine cases undergoing rectal cancer surgery were randomly divided into 3 groups, group I, II and III, 23 cases in each group. Both Zusanli (ST 36) and Sanyinjiao (SP 6) were selected for acupuncture anesthesia. Group I received general anesthesia after acupuncture induction, group II received acupuncture after general anesthesia, and group II received only general anesthesia. Minimum alveolar concentration (MAC) before and after operation was recorded.</p><p><b>RESULTS</b>MAC was (1.35 +/- 0.19) vol% in the group I, (1.49 +/- 0.22) vol% in the group II and (1.64 +/- 0.27) vol% in the group III. Acupuncture before and after general anesthesia could decrease respectively by about 0.29% and 0.15% of MAC in rectal cancer surgery undergoing general anesthesia, with a very significant difference (P < 0.01) or a significant difference (P < 0.05) among the 3 groups.</p><p><b>CONCLUSION</b>Acupuncture anesthesia has a certain adjuvant action for anesthesia and analgesia, and acupuncture before general anesthesia has a better action.</p>

Effects of heart displacement on hemodynamics during off-pump coronary artery bypass surgery / 中华麻醉学杂志

Objective To investigate the effects of heart displacement on hemodynamics during off-pump coronary artery bypass grafting (OP-CABG) while the sites for anastomosis were being exposed. Methods Forty-seven patients of both sexes (36 male, 11 female) aged 50-82 years undergoing OP-CABG were enrolled in the study. Preoperative cardiac function was assessed : class Ⅱ in 22 patients; Ⅲ in 23 and Ⅳ in 2 according to NYHA classification.The mean ejection fraction was 0.55?0.14 before surgery.They received on average 3.2 grafts. Premedication consisted of intramuscular morphine 10 mg, midazolam 3-5 mg and scopolamine 0.3 mg.Before induction of anesthesia ECG and SpO2 were monitored and radial artery was cannulated for continuous direct BP monitoring. Anesthesia was induced with midazolam 0.1 nig?kg-1 , fentanyl 4?g?kg-1 and pancuronium 0.1 mg?g-1 iv.The patients were mechanically ventilated after tracheal intubation and PETCO2 was maintained at about 40 mm Hg. Anesthesia was maintained with isoflurane and 50%-60% N2O in O2 and intermittent intravenous boluses of fentanyl and pancuronium. Swan-Ganz catheter which can continuously monitor mixed venous blood O2 saturation (SvO2) was placed in pulmonary artery via right internal jugular vein. SvO2, cardiac output (CO), BP, pulmonary arterial pressure (PAP) and HR were continuously monitored. Right atrial pressure (RAP) and PAWP were measured intermittently. Cardiac index (CI),stroke index (SI),systemic vascular resistance index (SVRI),PVRI, left and right ventricular work index (LVWI,RVWI) and left and right ventricular stroke work index (LVSWI,RVSWI) were calculated. The hemodynamic parameters were recorded after induction of anesthesia before surgery (T1,baseline),before heart displacement (T2), while anastomosis to anterior descending branch was being made (T3), while anastonosis to right coronary artery or posterior descending branch (T4) and to left circumflex artery or diagonal branch (T5) was being made, after normal heart position was resumed (T6) and at the end of operation (T7). Results While anastomosis to the anterior descending branch was being made (T3) SI and LVSWI significantly decreased as compared with the baseline (P