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经皮穴位电刺激减少腹股沟疝修补术患者术后镇痛需求:一项随机、安慰剂对照研究。

Transcutaneous Electrical Acupoint Stimulation Reduces Postoperative Analgesic Requirement in Patients Undergoing Inguinal Hernia Repair: A Randomized, Placebo-Controlled Study.

作者信息

Szmit Mateusz, Agrawal Siddarth, Goździk Waldemar, Kübler Andrzej, Agrawal Anil, Pruchnicki Piotr, Woźniak Marta, Nowak Matylda, Bartoszewicz Bartłomiej, Rudnicki Jerzy

机构信息

Department and Clinic of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-556 Wroclaw, Poland.

Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland.

出版信息

J Clin Med. 2021 Jan 4;10(1):146. doi: 10.3390/jcm10010146.

Abstract

Given the rising rate of opioid-related adverse drug events during postsurgical pain management, a nonpharmacologic therapy that could decrease analgesic medication requirements would be of immense value. We designed a prospective, placebo-and-randomized controlled trial to assess the clinical effect of transcutaneous acupoint electrical stimulation (TEAS) on the postoperative patient-controlled analgesia (PCA) requirement for morphine, as well as side effects and recovery profile after inguinal hernia repair. Seventy-one subjects undergoing inguinal hernia repair with a standardized anesthetic technique were randomly assigned to one of three analgesic treatment regimens: PCA + TEAS ( = 24); PCA + sham-TEAS (no electrical stimulation) ( = 24), and PCA only ( = 23). The postoperative PCA requirement, pain scores, opioid-related side effects, and blood cortisol levels were recorded. TEAS treatment resulted in a twofold decrease in the analgesic requirement and decreased pain level reported by the patients. In addition, a significant reduction of cortisol level was reported in the TEAS group at 24 h postoperatively compared to the sham and control groups. We conclude that TEAS is a safe and effective option for reducing analgesic consumption and postoperative pain following inguinal hernia repair.

摘要

鉴于术后疼痛管理期间阿片类药物相关不良药物事件的发生率不断上升,一种能够减少镇痛药物需求的非药物疗法将具有巨大价值。我们设计了一项前瞻性、安慰剂对照随机试验,以评估经皮穴位电刺激(TEAS)对腹股沟疝修补术后患者自控镇痛(PCA)吗啡需求量的临床效果,以及副作用和恢复情况。71名采用标准化麻醉技术接受腹股沟疝修补术的受试者被随机分配到三种镇痛治疗方案之一:PCA + TEAS(n = 24);PCA + 假TEAS(无电刺激)(n = 24),以及仅PCA(n = 23)。记录术后PCA需求量、疼痛评分、阿片类药物相关副作用和血皮质醇水平。TEAS治疗使镇痛需求量减少了两倍,并降低了患者报告的疼痛程度。此外,与假治疗组和对照组相比,TEAS组术后24小时皮质醇水平显著降低。我们得出结论,TEAS是减少腹股沟疝修补术后镇痛药物消耗和术后疼痛的一种安全有效的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b26e/7794768/3d1c4be12648/jcm-10-00146-g001.jpg

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