The clinical application of acupuncture combined with general anesthesia in gynecologic laparoscopic surgery / 中国基层医药

ABSTRACT

Objective To investigate the clinical application of acupuncture combined with general anesthe -sia in gynecologic laparoscopic surgery .Methods 60 ASA( the American society of anesthesiologists )Ⅰ-Ⅱpatients undergoing elective gynecologic laparoscopic surgery were randomly divided into the acupuncture group and control group.Patients in the acupuncture group were chosen Hegu (LI 4),Neiguan(PC 6) on both sides.After acupuncture, the two acupoints,electroacupuncture stimulated 20-30min,then administered general anesthesia ,electroacupuncture until surgery finished ,the control group received general anesthesia only .The drug dosages of the two groups was regu-lated,maintained anesthesia depth bispectral index ( BIS) between 40 and 60.The changes of the blood pressure ( BP) ,heart rate and BIS of the two groups at the same time points were observed;the propofol and remifentanil dos-age after the surgery ,the awaken time and extubation time ,OAA/S score and pain score after wake ,the happening of restlessness,chills,nausea and vomiting ,the usage of narcotic analgesics postoperation ,and the intraoperative aware-ness were recorded .The effect of acupuncture combined with general anesthesia was evaluated .Results Anesthetic dosage propofol of the acupuncture group [(7.44 ±1.30)μg· kg-1· h-1] was less than [(8.66 ±1.24)μg· kg-1· h-1] of the control group (t=3.720,P=0.001),remifentanil dosage was also less than the control group [acupunc-ture group (10.59 ±2.58)μg· kg-1· h-1,control group (11.93 ±2.27)μg· kg-1· h-1,t=2.168,P=0.034]. Compared with the basic value ,the BP values were higher at the time of intraoperation ,waking,extubation and 10 min after extubation (all P<0.05),the acupuncture group had more stable BP .Compared with the acupuncture group , heart rates in the control group were faster at extubation and 10min after extubation .Recovery time and extubation time of the acupuncture group were (9.05 ±2.36)min and (1.61 ±2.40)min,which were shorter than (12.50 ± 3.20)min and (15.90 ±3.37)min of the control group (P<0.05).Pain score(VAS) in the acupuncture group was lower than that of the control group .Consciousness score was higher in the acupuncture group ,the incidence rates of restlessness,chills were less.Conclusion The use of acupuncture combined with general anesthesia in gynecologic laparoscopic surgery can reduce the dosage of general anesthetics ,shorten the awaken time and extubation time ,increase the OAA/S score of the patients ,relieve pain ,and the recovery quality is higher .