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经皮穴位电刺激加速腹腔镜子宫肌瘤剔除术患者的康复:一项随机对照试验

Transcutaneous Electrical Acupoint Stimulation Accelerates the Recovery of Patients Undergoing Laparoscopic Myomectomy: A Randomized Controlled Trial.

作者信息

Pan Yuanyuan, Shao Yifan, Chi Zhanghuan, Jin Shenhui, Wang Junlu

机构信息

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

Department of Anesthesia, Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine, Hangzhou, People's Republic of China.

出版信息

J Pain Res. 2023 Mar 10;16:809-819. doi: 10.2147/JPR.S399249. eCollection 2023.

Abstract

PURPOSE

To evaluate transcutaneous electrical acupoint stimulation (TEAS) on the perioperative rehabilitation of patients undergoing laparoscopic myomectomy.

PATIENTS AND METHODS

One hundred and five women undergoing laparoscopic hysteromyomectomy were randomly divided into TEAS group (Group T) and control group (Group C). Propofol and remifentanil were used to stabilize patient blood pressure and keep BIS between 40 and 60. Group T patients received TEAS at LI4/PC6 30 minutes before the operation and lasting until the end of anesthesia, followed by TEAS at ST36/SP6 for 30 minutes in PACU. All required indicators were recorded.

RESULTS

Group T patients required lower dosages of remifentanil and vasoactive drugs, and had a reduced incidence of propofol injection pain and intraoperative hypotension compared to Group C. Group T also had a lower maximum NRS score in PACU, lower NRS scores at 1 hour and 24 hours, and a lower incidence of vomiting within 24 hours. In addition, the QoR-40 score for Group T at 24 hours after operation was higher in terms of physical comfort, emotional state, pain and total score.

CONCLUSION

TEAS can reduce the amount of anesthetic, maintain hemodynamic stability, reduce postoperative pain, reduce postoperative vomiting, enhance the recovery of gastrointestinal function, increase the quality of postoperative recovery and thus accelerate overall patient recovery.

摘要

目的

评估经皮穴位电刺激(TEAS)对腹腔镜子宫肌瘤切除术患者围手术期康复的影响。

患者与方法

105例行腹腔镜子宫肌瘤切除术的女性患者被随机分为TEAS组(T组)和对照组(C组)。使用丙泊酚和瑞芬太尼稳定患者血压并使脑电双频指数(BIS)维持在40至60之间。T组患者在手术前30分钟于双侧合谷穴/双侧内关穴接受经皮穴位电刺激,持续至麻醉结束,随后在麻醉后恢复室(PACU)于双侧足三里穴/双侧三阴交穴接受30分钟经皮穴位电刺激。记录所有所需指标。

结果

与C组相比,T组患者所需的瑞芬太尼和血管活性药物剂量更低,丙泊酚注射痛和术中低血压的发生率降低。T组在PACU的最大数字疼痛评分量表(NRS)得分也更低,术后1小时和24小时的NRS得分更低,24小时内呕吐发生率更低。此外,术后24小时T组在身体舒适度、情绪状态、疼痛及总分方面的术后恢复质量量表(QoR-40)得分更高。

结论

经皮穴位电刺激可减少麻醉药物用量,维持血流动力学稳定,减轻术后疼痛,减少术后呕吐,促进胃肠功能恢复,提高术后恢复质量,从而加速患者整体康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a557/10013582/6f98cf940d02/JPR-16-809-g0001.jpg

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