Centro Hospitalar Unimed Joinville, Rua Blumenau 314, Joinville-SC, Brazil.
Acupunct Med. 2011 Mar;29(1):16-20. doi: 10.1136/aim.2010.003251.
This study aims to evaluate the effects of preoperative electroacupuncture (EA) on the need for opioids in the postoperative stage of conventional cardiac surgery.
A prospective, randomised and controlled study was conducted at Unimed Hospital Centre in Joinville, SC, Brazil. The day before the surgery, 32 patients undergoing cardiac surgery were randomised into two groups: patients from the treatment group received preoperative EA at bilateral points (LI4-LI11, LR3-ST36, PC6-TE5) for 30 min with alternating frequencies of 3 and 15 Hz. Patients from the control group received sham transcutaneous electrical nerve stimulation (TENS). Use of fentanyl during the postoperative period was measured.
10 patients were excluded because of hemodynamic and ventilatory instability leaving 13 (10 male) in the treatment group and 9 (4 male) in the control group. The average total doses of fentanyl given were 13.1±2.2 and 16.3±1.6 μg/kg in the treatment and control groups respectively (p<0.002). The doses of patient controlled analgesia were 4.1±2.0 and 6.9±1.7 μg/kg in the treatment and control groups respectively (p<0.003). The number of boluses issued also differed (treatment 13.9±7.0 vs control 24.8±7.0, p<0.002). Pain intensity scores differed between the groups (treatment 2.5±1.1 vs control 4.0±2.0, p<0.04). One patient from the control group experienced drowsiness that justified a change in fentanyl infusion, as decided by the anaesthetist.
Preoperative electro-acupuncture in conventional cardiac surgery may reduce the postoperative consumption of fentanyl.
本研究旨在评估术前电针（EA）对常规心脏手术后阿片类药物需求的影响。
这项前瞻性、随机对照研究在巴西圣卡塔琳娜州若因维利的 Unimed 医院中心进行。手术前一天，将 32 名接受心脏手术的患者随机分为两组：治疗组患者接受双侧穴位（LI4-LI11、LR3-ST36、PC6-TE5）的术前 EA，频率为 3 和 15 Hz 交替，持续 30 分钟。对照组患者接受假经皮电神经刺激（TENS）。测量术后期间芬太尼的使用情况。
由于血流动力学和通气不稳定，10 名患者被排除在外，治疗组有 13 名（10 名男性），对照组有 9 名（4 名男性）。治疗组和对照组的芬太尼总剂量分别为 13.1±2.2 和 16.3±1.6 μg/kg（p<0.002）。患者自控镇痛的剂量分别为治疗组 4.1±2.0 和对照组 6.9±1.7 μg/kg（p<0.003）。发布的推注次数也不同（治疗组 13.9±7.0 与对照组 24.8±7.0，p<0.002）。两组疼痛强度评分也不同（治疗组 2.5±1.1 与对照组 4.0±2.0，p<0.04）。对照组有 1 名患者出现嗜睡，麻醉师决定改变芬太尼输注。
常规心脏手术中的术前电针可能会减少术后芬太尼的消耗。
