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颊针疗法对老年腹腔镜根治性胃切除术患者术后镇痛的影响:一项随机对照试验

Effects of buccal acupuncture on postoperative analgesia in elderly patients undergoing laparoscopic radical gastrectomy: a randomized controlled trial.

作者信息

Zhu Dong-Xue, Yang Yan-Ling, Yang Lei, Zhao Yuan-Yuan, Xie Ya-Yun, Wang Wei, Lv Jie, Yu Wan-You

机构信息

Department of Anesthesiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China.

Department of Anesthesiology, Wenjiang District People's Hospital of Chengdu, Chengdu, China.

出版信息

Front Neurol. 2024 Jun 26;15:1408360. doi: 10.3389/fneur.2024.1408360. eCollection 2024.

Abstract

OBJECTIVE

This study aimed to evaluate the efficacy and safety of buccal acupuncture on postoperative analgesia, perioperative stress response and adverse events in elderly patients undergoing laparoscopic radical gastrectomy.

METHODS

It was a prospective, outcome assessor-blinded, randomized controlled trial, involving 90 patients aged 65-80 years who were treated with an elective laparoscopic radical gastrectomy. They were randomly assigned to buccal acupuncture group (Group B) and control group (Group C). Buccal acupuncture was applied to patients of Group B before the induction of general anesthesia, while no additional application was given to those in Group C. Patient-controlled intravenous analgesia (PCIA) with sufentanil was postoperatively performed in both groups. Sufentanil consumption and the Visual Analog Scale (VAS) score within 48 h postoperatively were assessed as primary outcomes. Secondary outcomes included peripheral levels of stress markers, intraoperative consumptions of anesthetic drugs and postoperative recovery.

RESULTS

Patients in Group B presented significantly lower VAS scores within 24 h and less consumption of sufentanil within 48 h postoperatively (both  < 0.01). The awaking time, time to extubation and length of stay were significantly shorter in Group B than in Group C ( = 0.005, 0.001 and 0.028, respectively). Compared with Group C, stress response and inflammatory response within 24 h postoperatively were also significantly milder in Group B.

CONCLUSION

The use of buccal acupuncture before general anesthesia induction favors the postoperative analgesic effect and recovery in elderly patients undergoing laparoscopic radical gastrectomy, the mechanism of which involves relieving postoperative stress response and inflammatory response.

CLINICAL TRIAL REGISTRATION

This study was registered in the Chinese Clinical Trial Registry (www.chictr.org.cn) on 15/06/2023 (ChiCTR2300072500).

摘要

目的

本研究旨在评估颊针疗法对老年腹腔镜根治性胃切除术患者术后镇痛、围手术期应激反应及不良事件的疗效和安全性。

方法

这是一项前瞻性、结局评估者盲法、随机对照试验,纳入90例年龄在65 - 80岁接受择期腹腔镜根治性胃切除术的患者。他们被随机分为颊针组(B组)和对照组(C组)。B组患者在全身麻醉诱导前接受颊针治疗,而C组患者不进行额外治疗。两组术后均采用舒芬太尼患者自控静脉镇痛(PCIA)。术后48小时内舒芬太尼用量和视觉模拟评分(VAS)作为主要结局指标。次要结局指标包括应激标志物外周水平、术中麻醉药物用量及术后恢复情况。

结果

B组患者术后24小时内VAS评分显著更低,术后48小时内舒芬太尼用量更少(均P < 0.01)。B组患者的苏醒时间、拔管时间和住院时间均显著短于C组(分别为P = 0.005、0.001和0.028)。与C组相比,B组术后24小时内的应激反应和炎症反应也明显更轻。

结论

全身麻醉诱导前使用颊针疗法有利于老年腹腔镜根治性胃切除术患者的术后镇痛效果和恢复,其机制可能与减轻术后应激反应和炎症反应有关。

临床试验注册

本研究于2023年6月15日在中国临床试验注册中心(www.chictr.org.cn)注册(ChiCTR2300072500)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ff6/11231956/3ff51d4c5537/fneur-15-1408360-g001.jpg

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