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经皮穴位电刺激对老年无痛胃肠镜检查患者缺氧发生率的影响:一项随机对照试验

Effects of Transcutaneous Electrical Acupoint Stimulation on the Incidence of Hypoxia in Elderly Patients Undergoing Painless Gastrointestinal Endoscopy: A Randomized Controlled Trial.

作者信息

Zhou Wenyu, Wang Yu, Ye Pengcheng, Hu Song, Li Siyu, Wang Mingxia, Sheng Duanyang, Chen Yuanli, Shen Wang, Zhang Yi, Liu Feng, Zhang Wei, Lv Xin, Wang Xiangrui, Yang Hao

机构信息

Department of Anesthesiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.

Department of Anesthesiology and Pain Management, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China.

出版信息

Pain Res Manag. 2024 Dec 22;2024:1251246. doi: 10.1155/prm/1251246. eCollection 2024.

Abstract

Hypoxia is not uncommon in elderly patients during painless gastrointestinal endoscopy. This study aimed to determine the effectiveness of transcutaneous electrical acupoint stimulation (TEAS) in reducing the occurrence of hypoxia symptoms in elderly patients. Patients were randomly and equally grouped into sham control ( = 109) or TEAS group ( = 109) by using the random number table method. Patients in the TEAS group received electrical stimulation at the bilateral ST36 points 30 min before the examination until the end of the painless gastrointestinal endoscopy. Patients in the control group only had electrodes attached to bilateral nonacupoints in a similar pattern as the TEAS group without electrical stimulation. The primary endpoints measured were the incidence of hypoxia and severe hypoxia. The secondary endpoints included propofol dosage, sedation-related adverse events, hemodynamic parameters, surgical duration, patient recovery time, pain score, patient satisfaction, anesthesiologist satisfaction, and endoscopist satisfaction. Of the 251 patients who participated in this study, 218 patients ended up completing the final study. The primary outcome was that, compared with group control, the incidence of hypoxia in group TEAS was reduced by 11% (19.3% vs. 8.3%, =0.018) and the incidence of severe hypoxia did not show a significant change (7.3% vs. 2.8%, =0.122). And there was a significant decrease in the occurrence of patients requiring emergency airway assistance (increased oxygen flow: 16.5% vs. 6.4%, =0.019, jaw thrust: 11.0% vs. 3.7%, =0.038, mask-assisted ventilation: 5.5% vs. 1.8%, =0.015). TEAS can reduce the incidence of hypoxia in elderly patients undergoing painless gastrointestinal endoscopy. ClinicalTrials.gov identifier: ChiCTR2200059465.

摘要

在老年患者无痛胃肠内镜检查期间,缺氧情况并不少见。本研究旨在确定经皮穴位电刺激(TEAS)在降低老年患者缺氧症状发生率方面的有效性。采用随机数字表法将患者随机等分为假手术对照组(n = 109)和TEAS组(n = 109)。TEAS组患者在检查前30分钟接受双侧足三里穴位电刺激,直至无痛胃肠内镜检查结束。对照组患者仅以与TEAS组相似的方式将电极贴于双侧非穴位处,不进行电刺激。测量的主要终点是缺氧和严重缺氧的发生率。次要终点包括丙泊酚用量、镇静相关不良事件、血流动力学参数、手术持续时间、患者恢复时间、疼痛评分、患者满意度、麻醉医生满意度和内镜医生满意度。在参与本研究的251例患者中,218例患者最终完成了最终研究。主要结果是,与对照组相比,TEAS组的缺氧发生率降低了11%(19.3%对8.3%,P = 0.018),严重缺氧发生率未显示出显著变化(7.3%对2.8%,P = 0.122)。并且需要紧急气道辅助的患者发生率显著降低(增加氧流量:16.5%对6.4%,P = 0.019;下颌前推:11.0%对3.7%,P = 0.038;面罩辅助通气:5.5%对1.8%,P = 0.015)。TEAS可降低老年患者无痛胃肠内镜检查期间的缺氧发生率。ClinicalTrials.gov标识符:ChiCTR2200059465。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdf9/11682864/6f06007dd353/PRM2024-1251246.001.jpg

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