Impacts of the transcutaneous electrical acupoint stimulation on EC50 in the remifentanil inhibition of tracheal intubation response / 中国针灸

<p><b>OBJECTIVE</b>To explore the impacts on EC50 in the remifentanil inhibition of tracheal intubation response by the transcutaneous electrical acupoint stimulation (TEAS) at Hegu (LI 4) and Neiguan (PC 6).</p><p><b>METHODS</b>Forty patients with selective surgery undergoing endotracheal intubation with intravenous general anesthesia were divided into I to II degree by the American Society of Anesthesiologists (ASA) and were randomized into an observation group and a control group, 20 cases in each one. Before general anesthesia induction, in the observation group, the transcutaneous electric stimulation was applied to bilateral Hegu (LI 4) and Neiguan (PC 6) for 30 min, with dense-disperse wave, 2 Hz/100 Hz in frequency; in the control group, the sham-stimulation was applied to the acupoints, with the lamp on, but without electric current output. Afterwards, the general anesthesia induction started. When the target concentration of propofol and remifentanil was stabilized at the preset value, the endotracheal intubation was conducted. Dixon sequential method was applied for the determination of ECs in remifentanil inhibition of tracheal intubation response.</p><p><b>RESULTS</b>The level of EC50 in remifentanil inhibition of tracheal intubation response was 3. 46 ng/mL, 95% confidence interval was 2. 80 ng/ml to 4. 27ng/mL in the observation group; those were 4. 18 ng/mL and 3. 30 ng/mL to 5. 29 ng/mL in the control group separately. The differences were significant in comparison of the two groups (P<0. 01).</p><p><b>CONCLUSION</b>TEAS apparently reduces EChe in the remifentanil inhibition of tracheal intubation response by around 17%as.</p>

Efficacy of acupuncture intervention on urinary retention after spinal anesthesia / 中国针灸

<p><b>OBJECTIVE</b>To observe the acupuncture effect on urinary retention after spinal anesthesia.</p><p><b>METHODS</b>One hundred and fifty-four patients with spinal anesthesia were randomized into an observation group (80 cases) and a control group (74 cases). In the observation group, the electroacupuncture was applied to bilateral Fushe (SP 13) and Shuidao (ST 28); 2 Hz/50 Hz, retaining for 30 min. One treatment was required. In the control group, no any intervention was applied after operation. The incidence of the postoperative urinary retention, the time of the first automatic micturition since 30 min after spinal anesthesia, the volume of the first micturition, the postoperative urine condition, the lower abdominal distention, incomplete urination and the others were observed.</p><p><b>RESULTS</b>The incidence of urinary retention in the observation group was lower than that in the control group; the first automatic micturition in 30 min after spinal anesthesia was earlier than that in the control group; the comfortable urination rate was higher than that in the control group; the incidence of incomplete urination and lower abdominal distention were lower than those in the control group. The differences were significant in comparison of the two groups (all P<0.05).</p><p><b>CONCLUSION</b>Acupuncture apparently shortens the time of first automatic micturition after spinal anesthesia and promotes the recovery of bladder urinary reflection. This therapy acts on promoting urination and reducing postoperative urinary retention.</p>

Related factors for postoperative urinary retention in patients with intrathecal anesthesia / 实用医学杂志

Objective To investigate the related factors for postoperative urinary retention in patients with intrathecal anesthesia. Methods Collect 230 patients of orthopaedic surgery with intrathecal anesthesia in our hospital from June 2012 to June 2013. Prospective analysis the related factors of postoperative urinary retention in patients with intrathecal anesthesia. Results 48 cases have postoperative urinary retention from 230 patients of orthopaedic surgerywith intrathecal anesthesia. Difference of urinary retention group and unurinary retention group is statistically significant (P 0.05) in Sex, body mass index, smoking history, the mode of anesthesia Age, operation time, intraoperative rehydration, anesthetic dosage ≥11.25 mg and postoperative analgesia are the risk factors of postoperative urinary retention with multiariable Logistic regression analysis. The urine excretion before anesthesia are protective factors. Conclusion postoperative urinary retention with intrathecal anesthesia is many factors caused by a temporary performance of bladder dysfunction , Perioperative appropriate management (minimize anesthetic doses, shorten the operation time, control intraoperatie rehydration , preoperative try to drain urine ) can reduce the occurrence of postoperative urinary retention.