针刺麻醉与局部麻醉对慢性鼻炎下鼻甲肥大行低温等离子射频消融术时血压、心率影响的对照研究

Contrast Study of Acupuncture Anesthesia and Local Anesthesia: Their Effects on the Blood Pressure and the Heart Rate in Chronic Rhinitis Patients Accompanied Inferior Turbinate Hypertrophy in Low Temperature Radiofrequency Ablation

目的比较针刺麻醉与局部麻醉用于慢性鼻炎下鼻甲肥大低温等离子射频消融术对患者血压和心率的影响。方法慢性鼻炎伴下鼻甲肥大住院患者61例,随机分为针麻组(31例)和对照组(30例)。两组分别在针刺麻醉和常规局部麻醉下行射频消融术。记录并比较两组患者入室10min、术前即刻、术中和术后5min收缩压(SP)、舒张压(DP)、平均压(MP)及心率(HR)。结果与对照组同期比较,术中及术后各时间点针麻组SP、DP、MP和HR均降低,其中两组右侧第2点消融时SP及左侧第2点消融时HR比较,差异均有统计学意义(P<0.05)。与本组入室10min比较,对照组右侧第1次消融及左侧第2次消融时SP,右侧第2次消融及左侧第1次消融时SP、DP、MP均明显升高,差异有统计学意义(P<0.05,P<0.01)。针麻组术中、术后各时间点SP、DP、MP和HR以及对照组HR与本组入室10min和术前即刻比较,差异均无统计学意义(P>0.05)。结论行针刺麻醉的患者其术中血压及心率波动较局部麻醉者小,表明针刺镇痛麻醉效果优于局部麻醉。

Objective To compare the effects of acupuncture anesthesia （AA） and local anesthesia （LA） on the blood pressure （BP） and the heart rate （HR） in chronic rhinitis patients accompanied inferior turbinate hypertrophy in low temperature radiofrequency ablation （RFA）. Methods Totally 61 chronic rhinitis patients accompanied inferior turbinate hypertrophy were randomly assigned to the AA group （31 cases） and the control group （：30 cases）. All pa- tients received RFA respectively under AA and RA. Their heart rate （HR）, systolic pressure （： SP）, diastolic pressure （： DP）, and mean pressure （MP） were recorded and compared at 10 minutes after their entry into the operating room, immediately before surgery, intraoperation, and 5 min after operation. Results When compared with the control group at the same time points, the SP, DP, MP, and HR all decreased at intraoperation and 5 min after operation in the AA group. There was statistical difference in the SP on the right side at the 2nd melting point and the HR on the left side at the 2nd melting point between the two groups （P〈0. 05）. Compared with the same group at 10 min after entry into the operating room, the SP on the right side at the 1st melting point, the SP, DP, and MP on the right side at the 2nd melt- ing point, the SP, DP, and MP on the left side at the 1st melting point, and the SP on the left side at the 2nd melting point all obviously increased with statistical difference （P〈0. 05, P〈0. 01 ）. When compared with the same group at 10 min after entry into the operating room and immediately before surgery, there was no statistical difference in the SP, DP, MP, or HR of the AA group at intraoperation and 5 min after operation （ P〉0. 05）. When compared with the same group at 10 min after entry into the operating room and immediately before surgery, there was no statistical difference in HR of the control group at intraoperation and 5 min after operation （ P〉O. 05）. Conclusion Patients undergoing AA had less fluctuation of the BP and the HR, indicating AA had better analgesic effects.