Gemma Marco, Nicelli Elisa, Gioia Luigi, Moizo Elena, Beretta Luigi, Calvi Maria Rosa
Department of Anesthesia and Neurointensive Care, San Raffaele Scientific Institute, 20132 Milan, Italy.
J Integr Med. 2015 Mar;13(2):99-104. doi: 10.1016/S2095-4964(15)60159-5.
Acupuncture anesthesia was created in the 1950's in China and continues to be used there today during most major surgeries. It is widely used in China for such complex operations as brain, heart, and abdominal surgery. It is popular in China because it is economical, practical, and beneficial to the patients. With acupuncture anesthesia there is less bleeding during surgery and there is also quicker post-operative recovery.
This randomized prospective study aims at comparing the effect of two acupoints (Yongquan, KI1 and Renzhong, DU26) with sham acupuncture and no acupuncture on the time to recovery of consciousness after general anesthesia by means of the Bispectral Index monitor (BIS).
DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This is a prospective randomized controlled study. We randomly assigned 50 patients to 5 groups during recovery from surgical anesthesia. Four groups had acupuncture on KI1 (group A), DU26 (groups B), both KI1 and DU26 (group C), and sham points (group D), and one had no acupuncture (group E).
Bispectral Index (BIS), time to spontaneous eye opening, time to tracheal extubation, and time to following commands were measured as the main outcome measures.
Time to spontaneous eye opening differed among groups (P=0.002), as well as time to tracheal extubation (P<0.000 1) and time to following commands (P=0.000 6). BIS values differed significantly among groups both 5 and 10 min after the end of anesthesia (P<0.000 1 and P=0.000 4, respectively). BIS values of groups D and E were lower than those of the other groups and those of group C were higher. The same pattern was observed also 15 and 30 min after the end of anesthesia, although the difference among groups was not significant at these time points (P=0.164 and P=0.104, respectively).
Acupuncture on DU26 and KI1 accelerates recovery of consciousness after general anesthesia. Moreover, a possible synergistic effect of DU26 and KI1 is suggested. This issue may play a role in the optimization of operating room management and raise interest about the usefulness of acupuncture on unconsciousness states of different nature.
针刺麻醉于20世纪50年代在中国创立,至今在大多数大型手术中仍被广泛应用。它在中国被广泛用于脑部、心脏和腹部等复杂手术。它在中国很受欢迎,因为它经济、实用且对患者有益。使用针刺麻醉时,手术中出血较少,术后恢复也更快。
本随机前瞻性研究旨在通过脑电双频指数监测仪(BIS)比较两个穴位(涌泉,KI1和人中,DU26)与假针刺及不针刺对全身麻醉后意识恢复时间的影响。
设计、场所、参与者和干预措施:这是一项前瞻性随机对照研究。在手术麻醉恢复期间,我们将50例患者随机分为5组。四组分别针刺KI1(A组)、DU26(B组)、KI1和DU26(C组)以及假穴位(D组),一组不进行针刺(E组)。
测量脑电双频指数(BIS)、自主睁眼时间、气管拔管时间和对指令做出反应的时间作为主要观察指标。
自主睁眼时间在各组间存在差异(P = 0.002),气管拔管时间(P < 0.0001)和对指令做出反应的时间(P = 0.0006)也存在差异。麻醉结束后5分钟和10分钟时,各组间BIS值差异显著(分别为P < 0.0001和P = 0.0004)。D组和E组的BIS值低于其他组,C组的BIS值较高。在麻醉结束后15分钟和30分钟时也观察到相同的模式,尽管此时各组间差异不显著(分别为P = 0.164和P = 0.104)。
针刺DU26和KI1可加速全身麻醉后意识的恢复。此外,提示DU26和KI1可能存在协同作用。这一问题可能在优化手术室管理中发挥作用,并引发人们对针刺在不同性质昏迷状态下效用的关注。