Grech Dennis, Li Zhifeng, Morcillo Patrick, Kalyoussef Evelyne, Kim David D, Bekker Alex, Ulloa Luis
Department of Anesthesiology, New Jersey Medical School, Rutgers University, Newark, NJ, USA.
Laboratory of Surgical Immunology, Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ, USA.
J Acupunct Meridian Stud. 2016 Oct;9(5):234-241. doi: 10.1016/j.jams.2016.03.009. Epub 2016 Apr 4.
Neuronal stimulation improves physiological responses to infection and trauma, but the clinical potential of this strategy is unknown. We hypothesized that transdermal neural stimulation through low-frequency electroacupuncture might control the immune responses to surgical trauma and expedite the postoperative recovery. However, the efficiency of electroacupuncture is questioned due to the placebo effect. Here, electroacupuncture was performed on anesthetized patients to avoid any placebo. This is a prospective double-blinded pilot trial to determine whether intraoperative electroacupuncture on anesthetized patients improves postoperative recovery. Patients with electroacupuncture required 60% less postoperative analgesic, even they had pain scores similar to those in the control patients. Electroacupuncture prevented postoperative hyperglycemia and attenuated serum adrenocorticotropic hormone in the older and heavier group of patients. From an immunological perspective, electroacupuncture did not affect the protective immune responses to surgical trauma, including the induction of interleukin-6 and interleukin-10. The most significant immunological effect of electroacupuncture was enhancing transforming growth factor-β1 production during surgery in the older and lighter group of patients. These results suggest that intraoperative electroacupuncture on anesthetized patients can reduce postoperative use of analgesics and improve immune and stress responses to surgery.
神经元刺激可改善对感染和创伤的生理反应,但该策略的临床潜力尚不清楚。我们假设通过低频电针进行经皮神经刺激可能控制对手术创伤的免疫反应并加速术后恢复。然而,由于安慰剂效应,电针的有效性受到质疑。在此,对麻醉患者进行电针以避免任何安慰剂效应。这是一项前瞻性双盲试点试验,旨在确定对麻醉患者进行术中电针是否能改善术后恢复。接受电针治疗的患者术后镇痛需求减少60%,即便他们的疼痛评分与对照组患者相似。电针预防了老年和体重较大组患者术后高血糖并减弱了血清促肾上腺皮质激素水平。从免疫学角度来看,电针不影响对手术创伤的保护性免疫反应,包括白细胞介素-6和白细胞介素-10的诱导。电针最显著的免疫学作用是在老年和体重较轻组患者手术期间增强转化生长因子-β1的产生。这些结果表明,对麻醉患者进行术中电针可减少术后镇痛药的使用,并改善对手术的免疫和应激反应。
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