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经皮穴位电刺激对经蝶窦垂体瘤切除术患者围手术期静脉麻醉的影响

[Effect of transcutaneous acupoint electric stimulation on perioperative intravenous anesthesia in patients of transsphenoidal pituitary tumor resection].

作者信息

Chen Xue, Wang Bao-Guo, Li Jin, An Li-Xin

机构信息

Department of Anesthesiology, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing 100050, China.

出版信息

Zhongguo Zhen Jiu. 2013 Aug;33(8):732-6.

Abstract

OBJECTIVE

To observe the impacts of transcutaneous acupoint electric stimulation on hemodynamics, anesthetic and relevant complications in patients of transsphenoidal pituitary tumor resection (TPTR).

METHODS

Ninety cases of the selective TPTR were randomized into a transcutaneous acupoint electric stimulation group (group T), a sham-acupoint group (group S) and a control group (group C); 30 cases in each one. In group T, the transcutaneous acupoint electric stimulation at Hegu (LI 4), Waiguan (TE 5), Jinmen (BL 63), Taichong (LR 3), Zusanli (ST 36) and Qiuxu (GB 40). In group S, the transcutaneous acupoint electric stimulation was applied to the sham-acupoints. In group C, the acupoints selected were same as those in group T, but the electrode pads were just attached on the related points with no-electric stimulation. The electric stimulation lasted from analgesic induction till the end of the operation. The endotracheal intubation was done under the induction by propofol, fentanyl and vecuronium bromide. Propofol and remifentanil were maintained till the end of operation. Blood pressure, heart rate, bispectral index (BIS) value, anesthetic and postoperative recovery situation were recorded.

RESULTS

The hemodynamics maintained stably in each group. In group T, the mean arterial pressure 1 min after intubation, after extubation and during directional force recovery was all lower than the other two groups respectively (all P<0.05). In group T, the effect-site concentration of fentaryl in the exposure saddle area and tumor removal stage was lower than the other two groups (all P<0.05). In 24 h after operation, 2 cases presented nausea and vomiting in group C. There were no relevant complications in the rest groups.

CONCLUSION

The transcutaneous acupoint electric stimulation improves the stability of hemodynamics in perioperative stage, reduces the intraoperative opi oids dosages and improves the quality of anesthetic recovery.

摘要

目的

观察经皮穴位电刺激对经蝶窦垂体瘤切除术(TPTR)患者血流动力学、麻醉及相关并发症的影响。

方法

将90例择期TPTR患者随机分为经皮穴位电刺激组(T组)、假穴组(S组)和对照组(C组),每组30例。T组于合谷(LI 4)、外关(TE 5)、金门(BL 63)、太冲(LR 3)、足三里(ST 36)和丘墟(GB 40)进行经皮穴位电刺激。S组于假穴位进行经皮穴位电刺激。C组选取与T组相同的穴位,但电极片仅贴于相关穴位,不进行电刺激。电刺激从镇痛诱导开始持续至手术结束。在丙泊酚、芬太尼和维库溴铵诱导下进行气管插管。丙泊酚和瑞芬太尼维持至手术结束。记录血压、心率、脑电双频指数(BIS)值、麻醉及术后恢复情况。

结果

各组血流动力学均维持稳定。T组插管后1 min、拔管后及定向力恢复时的平均动脉压均分别低于其他两组(均P<0.05)。T组暴露鞍区及肿瘤切除阶段芬太尼的效应室浓度低于其他两组(均P<0.05)。术后24 h,C组有2例出现恶心呕吐。其余组无相关并发症。

结论

经皮穴位电刺激可提高围手术期血流动力学稳定性,减少术中阿片类药物用量,改善麻醉恢复质量。

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