Li Jian-Li, Wang Xue-Jiao, Rong Jun-Fang
Department of Anesthesiology, Hebei General Hospital, Shijiazhuang 050051, China.
Zhen Ci Yan Jiu. 2020 Nov 25;45(11):920-3. doi: 10.13702/j.1000-0607.200060.
To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) of different acupoint combinations on postoperative nausea and vomiting (PONV) and serum motilin (MTL) content in patients undergoing laparoscopic surgery, so as to provide evidence for clinical selection of suitable acupoint compatibility.
A total of 140 patients undergoing elective laparoscopic surgery were randomly divided into general anesthesia (GA) control, TG ［Neiguan (PC6) + Hegu (LI4)］, TG ［PC6 + LI4 + Zusanli (ST36)］, and TG ［PC6 + LI4 + ST36 + Sanyinjiao (SP6)］ groups, with 35 cases in each group. Patients of the TG, TG and TG groups received TEAS (2 Hz/100 Hz, 3-8 mA) of the above mentioned acupoint (bilateral) groups for 30 min before the induction of anesthesia until the end of the operation. Patients of the GA control group received intravenous injection of Midazolam, Sufentanil, Propofol, Rocuronium Bromide, etc. The blood sample (4 mL) from the right median cubital vein was collected at the time of patient's entry, 12 and 24 h after surgery, respectively, for measuring MTL concentration by enzyme-linked immunosorbent assay. The incidence of early and late PONV and changes of PONV degree within 24 h after surgery were recorded.
The serum MTL concentrations were significantly decreased at 12 h after surgery in all the 4 groups (<0.05), and decreased at 24 h after surgery in GA and TG2 groups vs their own pre-surgery (P < 0.05), and considerably higher at both 12 and 24 h after surgery in the TG, TG and TG groups than in the GA control group (<0.05), and also evidently higher in the TG and TG groups than in the TG group (<0.05). The incidence of PONV was significantly lower in the TG, TG and TG groups than in the GA control group in the early and late periods (except TG group) of surgery (<0.05). The number of patients with PONV grade Ⅰ was significantly larger in the TG, TG and TG groups than in the GA control group at 24 h after surgery (<0.05), suggesting a mild PONV in more patients undergoing TEAS.
TEAS has a preventive effect on PONV in patients undergoing laparoscopic surgery, which may be related to its effect in reducing serum MTL concentration. The preventive effect of TEAS of PC6 + LI4 + ST36 and PC6 +LI4 + ST36 + SP6 is similar and better than TG (two acupoints) group.
观察不同穴位组合的经皮穴位电刺激（TEAS）对腹腔镜手术患者术后恶心呕吐（PONV）及血清胃动素（MTL）含量的影响，为临床选择合适的穴位配伍提供依据。
将140例行择期腹腔镜手术的患者随机分为全身麻醉（GA）对照组、TG［内关（PC6）+合谷（LI4）］组、TG［PC6+LI4+足三里（ST36）］组和TG［PC6+LI4+ST36+三阴交（SP6）］组，每组35例。TG、TG和TG组患者在麻醉诱导前30分钟接受上述穴位（双侧）组的TEAS（2Hz/100Hz，3 - 8mA），持续至手术结束。GA对照组患者静脉注射咪达唑仑、舒芬太尼、丙泊酚、罗库溴铵等。分别于患者入室时、术后12小时和24小时采集右肘正中静脉血样4mL，采用酶联免疫吸附测定法测定MTL浓度。记录术后早期和晚期PONV的发生率及术后24小时内PONV程度的变化。
4组患者术后12小时血清MTL浓度均显著降低（<0.05），GA组和TG2组术后24小时血清MTL浓度较术前降低（P<0.05），TG、TG和TG组术后12小时和24小时血清MTL浓度均显著高于GA对照组（<0.05），TG和TG组血清MTL浓度也显著高于TG组（<0.05）。手术早、晚期（TG组除外）PONV发生率TG、TG和TG组显著低于GA对照组（<0.05）。术后24小时TG、TG和TG组Ⅰ级PONV患者数量显著多于GA对照组（<0.05），提示更多接受TEAS的患者PONV程度较轻。
TEAS对腹腔镜手术患者的PONV有预防作用，可能与其降低血清MTL浓度的作用有关。PC6+LI4+ST36和PC6+LI4+ST36+SP6的TEAS预防效果相似且优于TG（双穴）组。
