Gu Chen-yi, Shen Li-rong, Ding Yi-hong, Lou Yi, Wu Huan-gan, Shi Zheng, Ma Xiao-peng
Department of Anesthesiology, Yueyang Integrated Medicine Hospital Affiliated to Shanghai University of TCM, Shanghai 200437, China.
Zhongguo Zhen Jiu. 2010 Aug;30(8):675-8.
To explore the effect of general anesthesia, acupuncture at acupoints compound general anesthesia and acupuncture at non-acupoints compound general anesthesia on the perioperative analgesic effect in patients with laparoscopic cholecystectomy.
Ninety patients scheduled to undergo laparoscopic cholecystectomy were randomly divided into a general anesthesia group (group A), an acupuncture at acupoints compound general anesthesia group (group B) and an acupuncture at non-acupoints compound general anesthesia group (group C), 30 cases in each group. General anesthesias were all induced by Fentanyl, Propofol and Vecuronium Bromide. The bilateral Hegu (LI 4), Neiguan (PC 6), Zusanli (ST 36) and Yanglingquan (GB 34) were selected in the group B, and the middle points of the line connecting the meridians where every acupoint mentioned above belonged and their lateral neighbor meridians selected in the group C. The dosage of anesthetics, the time of goggle and the time of evulsion cannulation and direction location in all the patients were compared, and the dosage of analgesia pump within 4, 6, 8, 24 and 44 hours and Visual Analogue Scale (VAS) of pain were recorded after surgery.
The dosage of Fentanyl in the group B was obviously lower than that in both the group A and the group C (both P<0.05), and the dosages of Propofol and Vecuronium Bromide in the group B were obviously lower than those in the group A (P<0.05, P<0.01). The time of goggle, evulsion cannulation and direction location in the group B were significantly shorter than those in the other groups (all P<0.01). After surgery, the dosage of analgesia pump in the group B was significantly fewer than that in the group C within 4 and 6 hours (both P<0.05), and it was significantly fewer than that in the group A within 4, 6, 8 hours (all P<0.05). The scores of VAS of pain at 44th hour after surgery in the group B were obviously lower than those in the other groups (both P<0.05).
Acupuncture at acupoints can enhance the anesthetic effect of compound general anesthesia and prolong the analgesia period. Acupuncture at non-points has a certain effect, but their effectiveness is less than that of acupoints. Thus, the acupoint has the specificity and accurate acupoint selection is the key factor affecting analgesia effect.
探讨全身麻醉、穴位针刺复合全身麻醉及非穴位针刺复合全身麻醉对腹腔镜胆囊切除术患者围手术期镇痛效果的影响。
将90例拟行腹腔镜胆囊切除术的患者随机分为全身麻醉组(A组)、穴位针刺复合全身麻醉组(B组)和非穴位针刺复合全身麻醉组(C组),每组30例。全身麻醉均采用芬太尼、丙泊酚和维库溴铵诱导。B组选取双侧合谷(LI 4)、内关(PC 6)、足三里(ST 36)和阳陵泉(GB 34),C组选取上述各穴位所属经络与其外侧相邻经络连线的中点。比较所有患者的麻醉药物用量、睁眼时间、拔管时间及定向定位时间,并记录术后4、6、8、24和44小时镇痛泵的用量及视觉模拟评分法(VAS)疼痛评分。
B组芬太尼用量明显低于A组和C组(均P<0.05),B组丙泊酚和维库溴铵用量明显低于A组(P<0.05,P<0.01)。B组的睁眼时间、拔管时间及定向定位时间明显短于其他组(均P<0.01)。术后,B组术后4、6小时镇痛泵用量明显少于C组(均P<0.05),术后4、6、8小时明显少于A组(均P<0.05)。B组术后44小时VAS疼痛评分明显低于其他组(均P<0.05)。
穴位针刺可增强复合全身麻醉的麻醉效果,延长镇痛时间。非穴位针刺有一定效果,但效果不如穴位针刺。因此,穴位具有特异性,准确选穴是影响镇痛效果的关键因素。