Yu Jian-ming, Qu Pi-sheng, Fan Hao, Wang Zhen, Jin Ya-bei, Tao Fan
Medicine Hospital of Zhejiang, Hangzhou 310003, China.
Zhen Ci Yan Jiu. 2010 Feb;35(1):43-6.
To observe the analgesic effect of transcutaneous electrical acupoint stimulation (TEAS) in assisting general anesthesia (GA) for radical operation of breast carcinoma so as to explore its clinical application value.
Sixty patients scheduled for radical operations of the breast carcinoma were randomly and equally divided into GA group and TEAS+ GA group. For GA, Propofol [4.5 microg/mL, target concentration; (3.0 +/- 0.5) microg/mL during operation] was used in combination with Sufentanil (0.25 microg/kg) and Cis-atracurium amine (0.2 mg/kg). TEAS (5-10 mA, 2 Hz/100 Hz) was applied to Hegu (LI 4)-Laogong (PC 8) and Neiguan (PC 6)-Waiguan (SJ 5) on the affected side of the body for 30 min. Heart rate (HR), mean aterial pressure (MAP), tube removing time and postoperative complications were recorded. Plasma beta-endorphin content was assayed by radioimmunoassay.
After anesthesia, patients with reduction in MAP in GA group were significantly more than those in TEAS+GA group (P < 0.05), and their HR decreased remarkably (P < 0.05). After tracheal intubation, MAP in TEAS+GA group kept relatively stable, which was superior to that of GA group (P < 0.05). In comparison with GA group, the patients' analepsia time and tube withdrawal time of TEAS+ GA group were significantly shorter; and the dosage of analgesics of TEAS+GA group was significantly smaller than that of GA group (P < 0.05). Patients with complications of pain, restlessness, drowsiness, nausea and vomitting were obviously fewer in TEAS + GA group than those in GA group. Compared with GA group, plasma beta-endorphin content in TEAS+GA group increased considerably 30 min after TEAS, 5 min after skin-incision and after operation (P < 0.05).
TEAS combined with general anesthesia for breast radical carcinoma operation can help keep a stable blood pressure during surgery, reduce the dosage of analgesics and strengthen pain relief. The analgesic effect of TEAS may be related to its effect in up-regulating plasma beta-endorphin level.
观察经皮穴位电刺激（TEAS）辅助全身麻醉（GA）用于乳腺癌根治术的镇痛效果，探讨其临床应用价值。
将60例拟行乳腺癌根治术的患者随机等分为GA组和TEAS+GA组。全身麻醉采用丙泊酚[4.5μg/mL，靶浓度；术中（3.0±0.5）μg/mL]联合舒芬太尼（0.25μg/kg）和顺式阿曲库铵（0.2mg/kg）。将TEAS（5-10mA，2Hz/100Hz）作用于患侧合谷（LI 4）-劳宫（PC 8）及内关（PC 6）-外关（SJ 5）30分钟。记录心率（HR）、平均动脉压（MAP）、拔管时间及术后并发症。采用放射免疫法测定血浆β-内啡肽含量。
麻醉后，GA组MAP下降患者明显多于TEAS+GA组（P<0.05），且HR显著降低（P<0.05）。气管插管后，TEAS+GA组MAP保持相对稳定，优于GA组（P<0.05）。与GA组比较，TEAS+GA组患者的苏醒时间和拔管时间明显缩短；TEAS+GA组镇痛药用量明显少于GA组（P<0.05）。TEAS+GA组疼痛、躁动、嗜睡、恶心呕吐等并发症患者明显少于GA组。与GA组比较，TEAS+GA组TEAS后30分钟、切皮后5分钟及术后血浆β-内啡肽含量明显升高（P<0.05）。
TEAS联合全身麻醉用于乳腺癌根治术可使术中血压保持稳定，减少镇痛药用量，增强镇痛效果。TEAS的镇痛作用可能与其上调血浆β-内啡肽水平有关。
