Xie Duowen, Shi Xiaoyuan, Zhang Yinxia
Department of Intensive Care Unit, Lanzhou University Second Hospital, Lanzhou, 730000, China.
Department of Medical Record, Lanzhou University Second Hospital, Lanzhou, 730000, China.
J Coll Physicians Surg Pak. 2018 Nov;28(11):817-820. doi: 10.29271/jcpsp.2018.11.817.
To analyse the effects of combined acupuncture anesthesia on surgical dosage and serum interleukin-4 (IL-4), interleukin-10 (IL-10) of pneumonectomy patients.
A randomised controlled trial (RCT).
Lanzhou University Second Hospital, Lanzhou, China, from January 2016 to November 2017.
A total of 110 patients undergoing pneumonectomy were randomly divided into group A and group B, with 55 cases in each group. Group A was treated with combined 2Hz acupuncture anesthesia, while group B was treated with combined 2Hz/100Hz acupuncture anesthesia. The additional propofol, fentanyl dosage, and changes in heart rate and systolic blood pressure 5 min before and during extubation were compared between the two groups. The serum IL-4 and IL-10 levels were measured 10 minutes after skin incision and 24 hours after surgery using ELISA. Pain was rated by visual analogue scale (VAS) at 24 hours after surgery.
There was no statistically significant difference between group A and group B in the intraoperative additional propofol and fentanyl dosags (p=0.541 and 0.719, respectively). There is no statistical difference in heart rate and systolic blood pressure between group A and group B at 5 minutes before and during extubation (p=0.151, 0.660 and 0.734, 0.528, respectively). There is no statistical difference between group A and group B in serum IL-4 and IL-10 levels 10 minutes after surgical incision (p=0.916 and 0.841, respectively). However, serum IL-4 and IL-2 levels in group A are statistically lower than that of group B at 24 hours after surgery (all p<0.001). The VAS score at 24 hours after surgery in group A was 2.44 ±0.71 points, which was significantly lower than that of group B (3.82 ±0.77 points, p<0.001).
Combined 2 Hz, 2 Hz/100 Hz acupuncture anesthesia need few anesthetic dosages of propofol and fentanyl to stabilise the patient's blood pressure and heart rate when intubated under general anesthesia; but combined 2 Hz acupuncture anesthesia can reduce IL-4 and IL-10 levels during surgery stress to a greater extent than the latter, and can effectively lower patients' serum IL-4, IL-10 expression after surgery.
分析联合针刺麻醉对肺叶切除患者手术用药剂量及血清白细胞介素 -4（IL -4）、白细胞介素 -10（IL -10）的影响。
一项随机对照试验（RCT）。
2016年1月至2017年11月，中国兰州大学第二医院。
将110例行肺叶切除术的患者随机分为A组和B组，每组55例。A组采用2Hz联合针刺麻醉，B组采用2Hz/100Hz联合针刺麻醉。比较两组拔管前5分钟及拔管时丙泊酚、芬太尼追加用量及心率、收缩压变化。采用酶联免疫吸附测定法（ELISA）于皮肤切开后10分钟及术后24小时测定血清IL -4和IL -10水平。术后24小时采用视觉模拟评分法（VAS）评估疼痛程度。
A组和B组术中丙泊酚和芬太尼追加用量差异无统计学意义（p分别为0.541和0.719）。A组和B组拔管前5分钟及拔管时心率和收缩压差异无统计学意义（p分别为0.151、0.660和0.734、0.528）。手术切口后10分钟A组和B组血清IL -4和IL -10水平差异无统计学意义（p分别为0.916和0.841）。然而，术后24小时A组血清IL -4和IL -10水平低于B组（所有p<0.001）。A组术后24小时VAS评分为2.44±0.71分，显著低于B组（3.82±0.77分，p<0.001）。
在全身麻醉插管时，2Hz、2Hz/100Hz联合针刺麻醉丙泊酚和芬太尼麻醉用量少，能稳定患者血压和心率；但2Hz联合针刺麻醉比2Hz/100Hz联合针刺麻醉在手术应激期能更大程度降低IL -4和IL -10水平，且能有效降低患者术后血清IL -4、IL -10表达。
