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针刺刺激的时机不影响麻醉需求。

The timing of acupuncture stimulation does not influence anesthetic requirement.

作者信息

Chernyak Grigory, Sengupta Papiya, Lenhardt Rainer, Liem Edwin, Doufas Anthony G, Sessler Daniel I, Akça Ozan

机构信息

*Department of Anesthesiology and Perioperative Medicine and †Outcomes Research™ Institute, University of Louisville, Kentucky.

出版信息

Anesth Analg. 2005 Feb;100(2):387-392. doi: 10.1213/01.ANE.0000142114.72117.E0.

Abstract

Studies suggest that acupuncture is more effective when induced before the induction of general anesthesia than afterwards. We tested the hypothesis that electro-acupuncture initiated 30 min before the induction reduces anesthetic requirement more than acupuncture initiated after the induction. Seven volunteers were each anesthetized with desflurane on 3 study days. Needles were inserted percutaneously at four acupuncture points thought to produce analgesia in the upper abdominal area and provide generalized sedative and analgesic effects: Zusanli (St36), Sanyinjiao (Sp6), Liangqiu (Sp34), and Hegu (LI4). Needles were stimulated at 2 Hz and 10 Hz, with frequencies alternating at 2-s intervals. On Preinduction day, electro-acupuncture was started 30 min before the induction of anesthesia and maintained throughout the study. On At-induction day, needles were positioned before the induction of anesthesia, but electro-acupuncture stimulation was not initiated until after the induction. On Control day, electrodes were positioned near the acupoints, but needles were not inserted. Noxious electrical stimulation was administered via 25-gauge needles on the upper abdomen (70 mA; 100 Hz; 10 s). The desflurane concentration was increased 0.5% when movement occurred and decreased 0.5% when it did not. These up-and-down sequences continued until volunteers crossed from movement to no movement four times. The P(50) of logistic regression identified desflurane requirement. Desflurane requirement was similar on the Control (mean +/- sd; 5.2% +/- 0.6%), Preinduction (5.0% +/- 0.8%), and At-induction (4.7% +/- 0.3%; P = 0.125) days. This type of acupuncture is thus unlikely to facilitate general anesthesia or decrease the requirement for anesthetic drugs.

摘要

研究表明,针刺在全身麻醉诱导前进行比在诱导后进行更有效。我们检验了这样一个假设:诱导前30分钟开始的电针比诱导后开始的针刺更能降低麻醉需求。七名志愿者在三个研究日分别接受地氟醚麻醉。在四个被认为可在上腹部产生镇痛作用并提供全身镇静和镇痛效果的穴位经皮插入针:足三里(St36)、三阴交(Sp6)、梁丘(Sp34)和合谷(LI4)。以2赫兹和10赫兹的频率刺激针,频率以2秒的间隔交替。在诱导前一天,在麻醉诱导前30分钟开始电针,并在整个研究过程中持续。在诱导时当天,在麻醉诱导前放置针,但直到诱导后才开始电针刺激。在对照日,电极放置在穴位附近,但不插入针。通过25号针在上腹部给予有害电刺激(70毫安;100赫兹;10秒)。当出现运动时,地氟醚浓度增加0.5%,当没有运动时,地氟醚浓度降低0.5%。这些增减序列持续进行,直到志愿者从运动变为无运动四次。逻辑回归的P(50)确定了地氟醚需求。对照日(平均值±标准差;5.2%±0.6%)、诱导前一天(5.0%±0.8%)和诱导时当天(4.7%±0.3%;P = 0.125)的地氟醚需求相似。因此,这种类型的针刺不太可能促进全身麻醉或降低麻醉药物的需求。

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