围术期复合韩氏穴位神经刺激仪对直肠癌患者术后镇痛的影响

Effect of perioperative stimulation with Han's acupoint nerve stimulator on postoperative analgesic in patients undergoing radical rectal cancer surgery

目的观察围术期复合韩氏穴位神经刺激仪(HANS)对直肠癌根治术患者术后镇痛效果的影响。方法择期行直肠癌根治术患者100例,随机分为HANS复合全麻加硬膜外麻醉组(H组)与全麻加硬膜外麻醉组(G组),每组50例。H组:入室HANS穴位电刺激30min后以全麻加硬膜外麻醉实施手术,电刺激持续至术毕;术后连续5dHANS刺激,每天30分钟;G组:全麻加硬膜外麻醉实施手术,不复合HANS。术后均行患者自控硬膜外镇痛(PCEA)。记录术后各时段痛觉VAS、镇静评分(SS)、术后24、48、72h应用镇痛药总量及BP、HR、SpO2情况。结果与G组相比,H组术后8h内VAS明显降低(P<0.05),术后24、48、72h应用镇痛药总量明显减少(P<0.05)。结论围术期HANS能明显增强直肠癌根治术患者术后早期镇痛效果,减少术后应用镇痛药的总量。

Objective To investigate the effect of perioperative stimulation with Han＇s acupoint nerve stimulator （HANS） on postoperative analgesia in patients undergoing radical rectal cancer surgery. Methods One hundred ASA class Ⅰ or Ⅱ patients were randomly divided into two groups. In group H, HANS was used to stimulate 30 rain before induction of anesthesia, and combined general-epidural anesthesia was performed with HANS stimulation going on until completion of the operation. HANS was used to stimulate 30 rain once a day for 5 days after the operation. The patients in group G were treated as in group H without HANS as the controls. Two groups received PCEA after operations. Postoperative VAS and SS scores, the amount of analgesic requirement, BP, HR, and SpO2 were recorded. Results VAS score was significantly lower in group H than that in group G at 8 h after surgery （P〈0.05）. The consumption of PCEA solution during 24,48 and 72 h after surgery was evidently less in group H than that in group G （P〈0.05）. Conclusion Perioperative stimulation with HANS may enhance the analgesic effect of PCEA and reduce the requirement of analgesic solution in the patients underwent rectal cancer surgery.