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经皮穴位电刺激联合全身麻醉用于微创肺癌手术镇静和术后镇痛的疗效:一项随机、双盲、安慰剂对照试验。

Efficacy of transcutaneous electrical acupoint stimulation combined with general anesthesia for sedation and postoperative analgesia in minimally invasive lung cancer surgery: A randomized, double-blind, placebo-controlled trial.

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education, Beijing), Department of Anesthesiology, Peking University Cancer Hospital and Institute, Beijing, China.

Neuroscience Research Institute and Department of Neurobiology, Peking University and Key Laboratory of Neuroscience of the Ministry of Education and the National Health Commission, Beijing, China.

出版信息

Thorac Cancer. 2020 Apr;11(4):928-934. doi: 10.1111/1759-7714.13343. Epub 2020 Feb 16.

Abstract

BACKGROUND

Multimodal opioid-sparing analgesia is a key component of an enhanced recovery pathway after surgery that aims to improve postoperative recovery. Transcutaneous electrical acupoint stimulation (TEAS) is assumed to alleviate pain and anxiety and to modify the autonomic nervous system. This study aimed to determine the efficacy of TEAS for sedation and postoperative analgesia in lung cancer patients undergoing thoracoscopic pulmonary resection.

METHODS

A total of 80 patients were randomized into two groups: the TEAS group and the sham TEAS combined with general anesthesia group. Postoperative pain levels at six, 24, 48 hours, and one month after surgery were measured using the visual analogue scale (VAS). Bispectral index (BIS) score during the TEAS prior to anesthetic induction, Observer's Assessment of Alertness/Sedation (OAAS) score, sufentanil consumption during postoperative patient-controlled intravenous analgesia (PCIA), number of total and effective attempts of PCIA pump use, and incidence of postoperative nausea and vomiting were recorded and analyzed statistically.

RESULTS

Patients in the TEAS group had significantly lower VAS scores at six, 24, and 48 hours after surgery (P < 0.01); lower BIS scores at 10, 20, and 30 minutes before induction (P < 0.01); lower levels of postoperative sufentanil consumption; lower number of PCIA attempts and effective rates (P < 0.01); lower incidences of nausea at 0, six, 24, and 48 hours; and lower incidence of vomiting at 24 hours after surgery (P < 0.05). The postoperative OAAS scores were similar between the groups.

CONCLUSIONS

TEAS could be a feasible approach for sedation and postoperative analgesia in thoracoscopic pulmonary resection.

摘要

背景

多模式阿片类药物节约型镇痛是手术后强化康复途径的一个关键组成部分,旨在改善术后恢复。经皮穴位电刺激(TEAS)被认为可以缓解疼痛和焦虑,并调节自主神经系统。本研究旨在确定 TEAS 用于胸腔镜肺切除术后肺癌患者镇静和术后镇痛的效果。

方法

共 80 例患者随机分为两组:TEAS 组和假 TEAS 联合全身麻醉组。术后 6、24、48 小时和 1 个月时采用视觉模拟评分(VAS)测量术后疼痛程度。记录麻醉诱导前 TEAS 前的脑电双频指数(BIS)评分、警觉/镇静观察评分(OAAS)、术后患者自控静脉镇痛(PCIA)期间舒芬太尼消耗、PCIA 泵总尝试和有效尝试次数以及术后恶心和呕吐的发生率,并进行统计学分析。

结果

TEAS 组患者术后 6、24 和 48 小时 VAS 评分显著降低(P<0.01);诱导前 10、20 和 30 分钟 BIS 评分降低(P<0.01);术后舒芬太尼消耗降低;PCIA 尝试次数和有效率降低(P<0.01);术后 0、6、24 和 48 小时恶心发生率降低;术后 24 小时呕吐发生率降低(P<0.05)。两组术后 OAAS 评分相似。

结论

TEAS 可能是胸腔镜肺切除术后镇静和术后镇痛的一种可行方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77bf/7113057/f58119b19f4b/TCA-11-928-g001.jpg

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