Department of Anesthesiology, Roskilde Hospital, Roskilde, Denmark.
Pain Med. 2010 Jul;11(7):1126-31. doi: 10.1111/j.1526-4637.2010.00878.x. Epub 2010 Jun 8.
In anesthetized patients, electro-acupuncture (EA) has been found to reduce sevoflurane-induced suppression of cranial and spinal motor responses to surgery without influencing the level of anesthesia. The underlying mechanisms are unclear. In the present study, blood samples were analyzed to evaluate if the increased clinical motor responses to surgery in patients subjected to EA under sevoflurane anesthesia are also reflected in higher plasma levels of catecholamines, adrenocorticotrophic hormone (ACTH), or cortisol.
Blood samples were obtained before anesthetic induction, soon after the study or control procedures had been completed under general anesthesia, and after 30 minutes of surgery under steady-state anesthesia with 1.8% of sevoflurane, in 45 healthy female patients, scheduled for sterilization by laparoscopy, randomized for bilateral 2 Hz-burst EA (study group; n = 22) or control (control group; n = 23) procedures.
Plasma levels of adrenaline were found to approach the higher preanesthetic level after 30 minutes of surgery in patients given EA stimulation but to remain low in control patients (P < 0.05)-in agreement with the stronger clinical motor responses to skin incision in the EA group. Plasma levels of noradrenaline, ACTH, and cortisol did not change in or differ between the two groups.
The clinical facilitation of both cranial and spinal motor responses to surgery in patients given acupuncture under sevoflurane anesthesia is associated with increased plasma levels of adrenaline, possibly reflecting sympathetic activation.
在麻醉患者中,电针(EA)已被发现可减少七氟醚麻醉引起的对手术的颅神经和脊髓运动反应的抑制,而不影响麻醉水平。其潜在机制尚不清楚。在本研究中,分析了血样,以评估在七氟醚麻醉下接受 EA 的患者对手术的临床运动反应增加是否也反映在血浆儿茶酚胺、促肾上腺皮质激素(ACTH)或皮质醇水平升高。
45 名健康女性患者在全身麻醉下接受腹腔镜绝育术,在麻醉诱导前、全身麻醉下研究或对照程序完成后不久、1.8%七氟醚稳定麻醉下 30 分钟手术时,采集血样,随机分为双侧 2 Hz 爆发 EA(研究组;n = 22)或对照(对照组;n = 23)程序。
研究组患者在接受 EA 刺激后,30 分钟手术时发现肾上腺素血浆水平接近术前较高水平,而对照组患者肾上腺素水平仍较低(P < 0.05),与 EA 组患者皮肤切口时更强的临床运动反应一致。两组患者的去甲肾上腺素、ACTH 和皮质醇血浆水平均无变化或无差异。
在七氟醚麻醉下接受针刺的患者对手术的颅神经和脊髓运动反应的临床促进与肾上腺素血浆水平升高有关,可能反映交感神经激活。