Lu Li, Ge Sheng-jin, Xue Zhang-gang
Department of Anesthesia, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032.
Chin J Integr Med. 2006 Mar;12(1):1-5. doi: 10.1007/BF02857421.
To observe the effect of electro-acupuncture (EA) on auto regressive with exogenous input model (ARX-model) auditory evoked index (AAI) in patients anesthetized with different anesthetics.
Forty-eight adult patients undergoing scheduled surgical operation were enrolled and divided into two groups (24 in each group) according to the anesthetics applied, Group A was anesthetized with propofol sedation and Group B with Isoflurane-epidural anesthesia. Group A was subdivided into three groups of low, middle and high concentration of target effect-site of 1.0 microg/ml, 1.5 microg/ml and 2.0 microg/ml through target controlled infusion (TCI) and Group B into 3 subgroups of minimum alveolar effective concentration of isoflurane (0.4 MAC, 0.6 MAC and 0.8 MAC for B1, B2 and B3 subgroups) respectively, with 8 patients in every subgroup. EA on acupoints of Hegu (LI4) and Neiguan (P6) was applied on all the patients during anesthesia, and the change of AAI at various time points was recorded.
In the three subgroups of Group A, levels of AAI were significantly elevated in the first few minutes after EA, and significantly lowered 20 min after EA in subgroup A2. While in the subgroups of Group B, except the elevating in Group B1 1-2 min after EA, levels of AAI remained unchanged at other time points.
Pain response could be reflected by AAI during EA. EA could enhance the sedative effect of propofol in middle concentration, but its effect on isoflurane epidural anesthesia is insignificant.
观察电针(EA)对不同麻醉方式下患者的自回归外源性输入模型(ARX模型)听觉诱发电位指数(AAI)的影响。
选取48例择期手术成年患者,根据麻醉方式分为两组(每组24例),A组采用丙泊酚镇静麻醉,B组采用异氟烷 - 硬膜外麻醉。A组通过靶控输注(TCI)分为目标效应室浓度低、中、高3组,分别为1.0μg/ml、1.5μg/ml和2.0μg/ml,B组分为异氟烷最小肺泡有效浓度3个亚组(B1、B2和B3亚组分别为0.4MAC、0.6MAC和0.8MAC),每组8例。所有患者在麻醉期间均针刺合谷(LI4)和内关(P6)穴位,并记录各时间点AAI的变化。
A组3个亚组中,电针后最初几分钟AAI水平显著升高,A2亚组电针20分钟后显著降低。而B组各亚组中,除B1亚组电针后1~2分钟AAI升高外,其他时间点AAI水平无变化。
电针期间AAI可反映疼痛反应。电针可增强中浓度丙泊酚的镇静效果,但对异氟烷硬膜外麻醉效果不明显。