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经皮穴位电刺激联合利多卡因预防丙泊酚注射痛的临床研究

Clinical Study on the Combination of Transcutaneous Electrical Acupoint Stimulation and Lidocaine for Preventing Propofol Injection Pain.

作者信息

Jin Dan, Pan Yuanyuan, Jin Wenjun, Yan Yixiu, Huang Luping, Wang Junlu

机构信息

Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, People's Republic of China.

出版信息

J Pain Res. 2022 Mar 15;15:745-755. doi: 10.2147/JPR.S356150. eCollection 2022.

Abstract

PURPOSE

Propofol is a widely used intravenous anesthetic in clinical practice. Lidocaine pretreatment is currently the most commonly used method to reduce the pain of propofol injection. However, propofol injection pain has not been eliminated and its incidence remains high. Transcutaneous electrical acupoint stimulation is a green therapy that combines transcutaneous electrical nerve stimulation therapy with the traditional acupuncture therapy of our motherland. This study investigated the effectiveness of transcutaneous electrical acupoint stimulation (TEAS) combined with lidocaine in preventing propofol injection pain and determined whether it can reduce postoperative complications and promote rapid postoperative recovery of patients.

PATIENTS AND METHODS

A total of 220 women scheduled to undergo hysteroscopic surgery were enrolled in the study. The included patients were randomly divided into four groups of 55 patients each: normal saline group (group K), lidocaine group (group L), TEAS group (group T), and lidocaine + TEAS group (group L + T). Patients in group K received 2 mL saline (0.9% NaCl) pre-injection before anesthesia induction. Group L received 40 mg lidocaine pre-injection (2 mL of 2% lidocaine) before anesthesia induction. Group T received 30 min of transcutaneous electrical stimulation at bilateral election Hegu, Neiguan, and 2 mL saline pre-injections before anesthesia induction. Group L + T received TEAS and lidocaine pre-injection.

RESULTS

The VAS scores and the four-point verbal rating scale of propofol injection were significantly different among the four groups. The prevalence of nausea, vomiting, abdominal pain, and abdominal distension after surgery among the four groups were statistically different. The bleeding days after surgery were significantly different among the four groups.

CONCLUSION

TEAS combined with lidocaine pre-injection reduced the incidence of propofol injection pain and significantly reduced patients' pain levels compared with single lidocaine pre-injection. TEAS can also reduce the incidence of postoperative nausea and vomiting, abdominal pain, and abdominal distension, shorten postoperative bleeding days, and accelerate the postoperative recovery of patients.

摘要

目的

丙泊酚是临床实践中广泛使用的静脉麻醉药。利多卡因预处理是目前减轻丙泊酚注射痛最常用的方法。然而,丙泊酚注射痛尚未消除,其发生率仍然很高。经皮穴位电刺激是一种将经皮电神经刺激疗法与祖国传统针灸疗法相结合的绿色疗法。本研究探讨经皮穴位电刺激(TEAS)联合利多卡因预防丙泊酚注射痛的有效性,并确定其是否能减少术后并发症,促进患者术后快速康复。

患者与方法

共有220例计划行宫腔镜手术的女性纳入本研究。纳入的患者被随机分为四组,每组55例:生理盐水组(K组)、利多卡因组(L组)、TEAS组(T组)和利多卡因+TEAS组(L+T组)。K组患者在麻醉诱导前预注2 mL生理盐水(0.9%氯化钠)。L组患者在麻醉诱导前预注40 mg利多卡因(2%利多卡因2 mL)。T组患者在麻醉诱导前接受双侧选定的合谷、内关穴位30分钟的经皮电刺激,并预注2 mL生理盐水。L+T组患者接受TEAS和利多卡因预注。

结果

四组患者丙泊酚注射时的视觉模拟评分(VAS)和四点口述分级评分有显著差异。四组患者术后恶心、呕吐、腹痛和腹胀的发生率有统计学差异。四组患者术后出血天数有显著差异。

结论

与单纯利多卡因预注相比,TEAS联合利多卡因预注降低了丙泊酚注射痛的发生率,并显著降低了患者的疼痛程度。TEAS还可降低术后恶心、呕吐、腹痛和腹胀的发生率,缩短术后出血天数,加速患者术后康复。

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