Résumé
OBJECTIVE@#To explore the effect of electroacupuncture on the improvement of insulin resistance after knee joint replacement based on the combined spinal and epidural anesthesia and postoperative epidural analgesia.@*METHODS@#Eighty patients with insulin resistance but normal blood glucose were randomly divided into a control group and an observation group, 40 cases in each group.Both groups of patients underwent combined spinal and epidural anesthesia and postoperative epidural analgesia for knee arthroplasty. On the basis of the treatment,electroacupuncture (EA) was applied during the operation and within 1 month after the operation in the observation group, and EA was used at Hegu (LI 4), Qihai (CV 6), Zhongwan (CV 12), Pishu (BL 20), Shenshu (BL 23), etc. once every other day. The control group was not treated with electroacupuncture. Fasting blood glucose and fasting insulin were recorded 30 min before surgery (T), immediately (T), 1 d (T), 3 d (T), 7 d (T) and 1 month (T) after surgery, and the insulin resistance (IR) index was calculated.@*RESULTS@#Compared with those at T time point, the IR index of the control group at T, T, T and T time points and the observation group at T, T, T time points were lower (all <0.05). Compared with the control group at the same time point, the IR index of the T and T time points in the observation group was significantly lower (both <0.05), and it was lower than the insulin resistance standard.@*CONCLUSION@#Combined spinal and epidural anesthesia and postoperative epidural analgesia can improve short-term insulin resistance. Combined with EA, the improvement of insulin resistance is more obviously and longer.