Efficacy of TEAS for general anesthesia preserving spontaneous breathing in patients undergoing thoracoscopic surgery / 中华麻醉学杂志

ABSTRACT

Objective@#To evaluate the efficacy of transcutaneous electrical acupoint stimulation (TEAS) for general anesthesia preserving spontaneous breathing in the patients undergoing thoracoscopic surgery.@*Methods@#Forty patients of both sexes, aged 18-67 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with Mallampati physical status Ⅰ or Ⅱ, scheduled for elective thoracoscopic lobectomy, were divided into 2 groups (n=20 each) using a random number table method: general anesthesia preserving spontaneous breathing group (group GS) and TEAS plus general anesthesia preserving spontaneous breathing group (group TE+ GS). Anesthesia was routinely induced and maintained, a laryngeal mask was placed, and patients kept spontaneous breathing in two groups.The bispectral index value was maintained at 45-60.Patient-controlled intravenous analgesia was used after operation, and visual analogue scale score was maintained<4 points.In group TE+ GS, Xinshu and Feishu acupoints ipsilateral to the operated side and bilateral Hegu and Neiguan acupoints were stimulated with a disperse-dense wave, frequency 2/100 Hz and intensity 5-15 mA starting from 30 min before anesthesia induction until the end of surgery.The mean arterial pressure (MAP), heart rate (HR) and respiratory rate (RR) were recorded before induction of anesthesia, immediately after start of operation, during thoracic exploration, immediate after lobectomy , and at 30 min and 1 h after lobectomy.The intraoperative MAP, HR, and RR were recorded when clinically significant events occurred in two groups.Central venous blood samples were simultaneously collected for determination of concentrations of cortisol, norepinephrine, epinephrine, and blood glucose in serum (by enzyme-linked immunosorbent assay). The highest value of PETCO2, the lowest value of SpO2, and consumption of anesthetic drugs were recorded.Duration of post-anesthesia care unit stay, time to first flatus, ambulation time, occurrence of nausea and vomiting, chest tube drainage time, development of surgical complications, length of postoperative hospital stay and hospitalization expenses were recorded.@*Results@#MAP, HR and RR all fluctuated within the normal range, and no clinically significant events occurred in two groups.Compared with group GS, the highest value of PETCO2 was significantly decreased, the lowest value of SpO2 was increased, the MAP and HR were decreased, the consumption of propofol and remifentanil was decreased, the cortisol, norepinephrine, epinephrine, and blood glucose concentrations in serum were decreased, the time to first flatus, ambulation time, chest tube drainage time and length of postoperative hospital stay were shortened, and the incidence of nausea and vomiting and hospitalization expenses were decreased in group TE+ GS (P<0.05).@*Conclusion@#TEAS can reduce the amount of opioids consumed in the perioperative period, effectively inhibits intraoperative stress responses, and is helpful in improving the early outcomes when used for general anesthesia preserving spontaneous breathing in the patients undergoing thoracoscopic surgery.