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OBJECTIVE@#To evaluate the effect of transcutaneous acupoint electrical stimulation (TEAS) at Neiguan (PC 6) on general anesthesia under preserving spontaneous breathing in thoracoscopic lobectomy.@*METHODS@#A total of 66 patients of primary lung cancer undergoing thoracoscopic lobectomy were divided to an observation group (33 cases, 1 case discontinued) and a control group (33 cases). In the observation group, TEAS at Neiguan (PC 6) was used 30 min before anesthesia induction till the end of surgery. The surgery time, maximum value of partial pressure of end-tidal carbon dioxide (PETCO2) and minimum value of oxygen saturation (SpO2) of the two groups were recorded. The dosage of propofol, sufentanil, remifentanil and dexmedetomidine were analyzed. Separately, before induction (T0), at the start of surgery (T1), thoracic exploration (T2) and lobectomy (T3), as well as 30 min (T4) and 60 min (T5) after lobectomy, the mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), serum cortisol (Cor) and norepinephrine (NE) were measured. The time of post anesthesia care unit (PACU) stay, ambulation, flatus, chest drainage and the incidence of nausea and vomiting were compared between the two groups.@*RESULTS@#The maximum value of PETCO2, the dosage of propofol and remifentanil in the observation group were lower than those in the control group (P < 0.05, P < 0.01), the minimum value of SpO2 in the observation group was higher than that of the control group (P < 0.01). At T1-T5, the MAP, HR, serum Cor and NE levels in the observation group were all lower than those in the control group (P < 0.05). The ambulation time, the time for the flatus, chest drainage time, and the incidence of nausea and vomiting in the observation group were all lower than those in the control group (P<0.001, P < 0.01).@*CONCLUSION@#For the general anesthesia under preserving spontaneous breathing in thoracoscopic surgery, TEAS at Neiguan (PC 6) relieves stress response, reduces opioids dosage and promotes postoperative recovery.
Subject(s)
Humans , Acupuncture Points , Carbon Dioxide , Flatulence , Propofol , Remifentanil , Anesthesia, General , Nausea , Norepinephrine , Electric StimulationABSTRACT
OBJECTIVE: To observe the prewarming effect of transcutaneous acupoint electrical stimulation (TAES) preconditioning of Dazhui (GV14) and Mingmen (GV4) in patients undergoing elective video-assisted thoracoscopic lobectomy, so as to determine whether TAES can improve intraoperative hypothermia. METHODS: A total of 80 patients undergoing elective video-assisted thoracoscopic lobectomy were randomly divided into TAES group (40 cases) and control group (40 cases). Before surgery, all the patients were transferred to the fixed area of an anesthetic preparation room by using a surgery cart carrying the same temperature sheets and quilts before surgery. TAES (2 Hz/100 Hz, 20-30 mA) was applied to Dazhui (GV14) and Mingmen (GV4) for 30 min for patients of the TAES group and the same sheet electrodes of EA stimulator were only attached to GV14 and GV 4 without electrical current transmission for patients in the control group. Then, these patients in the two groups were transferred to the operation room and treated by total intravenous anesthesia, and their anesthetic depth was monitored with bispectral index (BIS, between 45-60) and end-tidal carbon dioxide tension (PETCO2, between 30-45 mmHg). The auricular tympanic temperature was monitored, and when the temperature was below 35.5 ℃, forced-air blanket was used to warm the patient as the remedial measure. The same temperature of operation room, surgical drape, infusion solution and pleural lavage fluid were controlled. The patients' body temperature in the preparation room and operation room during surgery, incidence of hypothemia, blood pressure (BP), heart rate (HR), duration of anesthesia, duration of operation, blood loss volume, urine output, total infusion volume, recovery (awaking) time, and chills during recovery were recorded. RESULTS: The body temperature of patients in the TAES group was significantly higher than that in the control group at the time of entering the operation room (P0.05). CONCLUSION: TAES preconditioning of GV14 and GV4 can produce prewarming effect before anesthesia, shorten the awaking time and reduce the incidence of chills in the recovery period in patients undergoing elective video-assisted thoracoscopic lobectomy.
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OBJECTIVE: To observe the effect of transcutaneous acupoint electrical stimulation (TAES) on hemodynamic fluctuation caused by loosing tourniquet in the elderly patients undergoing knee joint replacement. METHODS: A total of 60 ASA (America Society Anesthesiologist) I or II elderly patients for elective knee joint replacement surgery were randomly divided into control group (30 cases) and TAES group (30 cases). Patients of both groups were treated by intravenous anesthesia, and monitored with bispectral index (BIS, between 45－60) for anesthesia depth, stroke volume variation (SVV) for fluid management, mean arterial pressure (MAP) and cardiac index (CI) for hemodynamic fluctuation evaluation, and with analgesia nociception index (ANI, between 50－70) for remifentanil dosage adjustment. TAES (2 Hz/100 Hz, 8－20 mA) was applied to bilateral Xinshu (BL 15), Feishu (BL 13), Neiguan (PC 6) and Hegu (LI 4) acupoints for 30 min first (followed by anesthesia induction and operation), and given continuously until 15 min after tourniquet loosing. Patients of the control group were only given with electrodes attachment without electrical stimulation. The levels of MAP, CI, and arterial blood pH, PaCO2, PaO2, base excess (BE) and lactic acid (Lac) 1 min before, and 5 and 15 min after tourniquet loosing, and the dosages of remifentanil and ephedrine after tourniquet loosing were recorded. RESULTS: The changed levels of MAP, CI and blood Lac at 5 min after tourniquet loosing (relevant to the baseline levels), and blood Lac content at 15 min after tourniquet loosing (relevant to 5 min after tourniquet loosing) were significantly lower in the TAES group than in the control group (P0.05). CONCLUSIONS: TAES has a positive effect on hemodynamics fluctuation caused by loosing tourniquet in the aged patients undergoing knee joint replacement.
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Objective To observe the effect of transcutanous acupoint electrical stimulation(TAES)and dexmedetomidine on postoperative cogni?tive dysfunction in female patients underwent laparoscopic surgery. Methods Nighty patients scheduled for laparoscopic surgery were recruited in this study and randomly divided into control group(group C,n=30),TAES group(group T,n=30)and dexmedetomidine group(group D,n=30). In group T,patients received TAES treatment 30 min before the anesthesia until the end of the surgery at Neiguan(PC 6)and Zusanli(ST 36). The frequency was 2/100 Hz. In group D,patients were intravenously administrated with dexmedetomidine(0.5μg/kg)before the induction. All the patients were given routine general anesthesia. Drugs induced were sulfentanyl,etomidate and cisatracurium. Sevoflurane was given to main?tain the bispectral index(BIS)between 40 and 55. The time of extubation and in PACU was recorded. The serum S100βlevel was assessed at pre?operation(T0),the end of operation(T1)and 24 h after operation(T2). Mini?mental state examination(MMSE)was adopted to evaluate and re?cord the changes in cognitive function 1 day before operation and 24 h after operation. Results The incidence rate of POCD in group T and group D were lower than that in group C(all P<0.05). The level of S100βin group T and group D was lower than those in group C at T1 and T2 separately (all P<0.05). The time of extubation and time in PACU in group D were longer than those in group C and group T(all P<0.05),and the incidence of bradycadia in group D was higher than that in the other groups(all P<0.05). Conclusion TAES and dexmedetomidine reduce the incidence of cognitive dysfunction,decrease the release of S100βprotein. However,dexmedetomidine increases bradycadia,and prolongs extubation time and stay time in PACU. Hence,TAES deserve to be recommended practically.
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Objective To evaluate the clinical efficacy of nerve-related acupoints electrical stimulation in preventing urinary retention after hemorrhoid surgery. Method Ninety-seven patients were randomized into two groups: the treatment group received nerve-related acupoints electrical stimulation 1 h after Milligan-Morgan hemorrhoidectomy for mixed hemorrhoids, while the control group was taken as a blank control. The incidence of postoperative urinary retention, residual urine volume after the first urination, general urinary condition score, and satisfaction evaluation were compared between the two groups. Result The incidence of postoperative urinary retention and residual urine volume after the first urinary were lower, and the general urination condition and satisfaction evaluation were higher in the treatment group compared to those in the control group. Conclusion Nerve-related acupoints electrical stimulation can prevent and reduce the adverse reactions such as urinary retention after hemorrhoidectomy, and it can effectively protect the bladder function and improve the prognosis.
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Objective To observe the clinical efficacy of transcutaneous acupoint electrical stimulation in intervening constipation during chemotherapy in breast cancer patients.Method Ninety breast cancer patients undergone chemotherapy were randomized into a treatment group and a control group, 45 cases in each group. The control group was intervened by conventional nursing care, while the treatment group was additionally intervened by transcutaneous acupoint electrical stimulation. The clinical efficacies were compared between the two groups.Result The total effective rate was 93.3% in the treatment group versus 73.3% in the control group, and the difference was statistically significant (P<0.01).Conclusion Transcutaneous acupoint electrical stimulation can effectively inhibit the incidence of constipation during chemotherapy in breast cancer patients.
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ObjectiveTo observe the effect of transcutaneous acupoint electrical stimulation (TAES) on the ovariangranulosa cell apoptosis-related proteins, Bcl-2 and Bax, as well as the oocyte quality in theolder women with kidney deficiency receiving in vitro fertilization-embryo transfer (IVF-ET).MethodSixty-six older women with kidney deficiency who were receiving IVF-ET because of the fallopian tube factor were randomized into a treatment group (intervened by TAES) and a control group (intervened by sham acupuncture), 33 in each group. The kidney-deficiency syndrome score, HCG E2/follicle count per day, excellent follicle rate, excellent embryo rate, and clinical pregnancy rate were observed and compared between the two groups; Western blot was used to detect the expression of protein Bcl-2 and Bax.ResultCompared to the control group, the treatment group had significant improvement in kidney-deficiencysymptoms (P0.05). The expression of Bcl-2 and Bax proteins were markedlycorrelatedwith IVF-related indexes (P<0.05).ConclusionTAES can improve the kidney-deficiency symptoms and the quality of oocyte and embryo inolder women; this action is possibly related to the regulation of expression of the cell apoptosis-related protein Bcl-2 and Bax, as well as the decrease ofgranulosecell apoptosis.