Zhang Jiamin, Zhang Hao, Zheng Junfei, Niu Cong, Zhu Shu, Hu Haiqing, Lu Ye, Zhu Meihua
Department of Anesthesiology, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210017, People's Republic of China.
Department of Anesthesiology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210011, People's Republic of China.
J Pain Res. 2025 Mar 13;18:1221-1229. doi: 10.2147/JPR.S501941. eCollection 2025.
Endoscopic treatment of early colon neoplasms has evolved as a valid and less traumatic alternative to surgical resection. It can usually be performed with sedation on an outpatient basis. The present study was performed to determine the safety and effectiveness of electroacupuncture (EA) versus propofol sedation during endoscopic submucosal dissection (ESD) for early colon neoplasm.
A total of 150 adult outpatients undergoing ESD were selected and divided into the EA combined with propofol group (EP group), remifentanil combined with propofol group (RP group), and propofol group (SP group), with 50 patients in each group. All patients received standard sedation with propofol. Acupuncture was performed before intravenous propofol injection in the EP group. A density wave of 1-3 mA, 2/100 hz current was administered for 20 min before the induction of anesthesia. The effectiveness of sedation was measured by satisfaction levels, and pain and sedation scores were measured by questionnaires. Respiratory and hemodynamic complications were monitored and compared as indices of safety.
Demographic data were comparable among the three groups. The total dose of propofol and the percentage of body movement in the EP group were lower than in the SP and RP groups (<0.01). The incidence of hypotension and bradycardia in the SP and RP groups was higher than in the EP group. Patients who received the EA intervention showed a significant reduction in hypoxemia. The endoscopists felt that the procedure was more favorable in the EP group, but, there was no significant difference of patient satisfaction scores among three groups.
Sedation with EA is effective and safe for patients undergoing ESD, and could improve the satisfaction levels of patients and gastroendoscopists.
早期结肠肿瘤的内镜治疗已发展成为一种有效且创伤较小的手术切除替代方法。通常可在门诊进行镇静状态下的操作。本研究旨在确定内镜黏膜下剥离术（ESD）治疗早期结肠肿瘤时，电针（EA）与丙泊酚镇静相比的安全性和有效性。
共选取150例接受ESD的成年门诊患者，分为电针联合丙泊酚组（EP组）、瑞芬太尼联合丙泊酚组（RP组）和丙泊酚组（SP组），每组50例。所有患者均接受丙泊酚标准镇静。EP组在静脉注射丙泊酚前进行针刺。在麻醉诱导前，给予1 - 3 mA、2/100赫兹电流的疏密波，持续20分钟。通过满意度评估镇静效果，通过问卷测量疼痛和镇静评分。监测并比较呼吸和血流动力学并发症作为安全性指标。
三组患者的人口统计学数据具有可比性。EP组丙泊酚总剂量和身体移动百分比低于SP组和RP组（<0.01）。SP组和RP组低血压和心动过缓的发生率高于EP组。接受电针干预的患者低氧血症明显减轻。内镜医师认为EP组操作更有利，但三组患者满意度评分无显著差异。
电针镇静对接受ESD的患者有效且安全，可提高患者和胃肠内镜医师的满意度。
