经皮穴位电刺激复合药物全麻行控制性降压的控压效应分析

Observation on Control Pressure Effects by Transcutaneous Electrical Acupoint Stimulation Combining General Anesthesia in Controlled Hypotension

目的:探讨经皮穴位电刺激复合药物全麻行控制性降压至不同平均动脉血压(MAP)水平的控压效应变化。方法:54只雄性比格犬随机分为9组,每组6只,控压组动物均以异氟烷复合硝普钠行控制性降压术,单纯全麻组不行控制性降压,实验组采用经皮穴位电刺激(TEAS)干预处理。结果:在行控制性降压至基础MAP60%水平时,在血压回升阶段,实验组动物MAP的回升速度和幅度均高于同水平对照组,在回升30min时基本恢复至基础水平,对照组仍显著低于其基础水平(P<0.05);与单纯全麻组相比,50%基础MAP对照组、40%基础MAP对照组苏醒时间明显增加(P<0.05);60%基础MAP、40%基础MAP实验组被动放血量明显减少(P<0.05),50%基础MAP、30%基础MAP实验组术中自然失血量明显减少(P<0.05)。结论:TEAS能加快机体MAP的恢复,并有效缩短了实验动物的苏醒时间;同时能不同程度的减少术中失血量,从而对机体起到保护作用。

Objective To observe the changes of mean arterial pressure （MAP） effects of controlled hypo- tension by transcutaneous electrical acupoint stimulation （TEAS） combining general anesthesia. Methods Fif- ty-four male beagles were randomly divided into nine groups： simple anesthesia group, 60%, 50%, 40% and 30% MAP control groups, 60%, 50% ,40% and 30% MAP experiment groups, each group had six dogs. The con- trolled pressure groups were administered the same anesthesia with Isofluane inhalation and intravenous sodium nitroprusside （SNP） for controlled hypotension, the simple anesthesia group was not treated with controlled hypo- tension. TEAS was applied in experiment groups. Results At 60% base level of line-induced hypotension, in the recovery phase of blood pressure, the rising speed and amplitude of experimental groups MAP were higher than the levels of the control group, at the time of rising for 30miniutes, the experimental groups MAP recovered to the baseline level. Compared with the simple anesthesia group, in the control groups recovery time of 50% MAP and 40% MAP were significantly increased（P〈 0.05）; in the experimental groups passive release blood of 60% MAP and 40% MAP were less than in the simple anesthesia group （P 〈 0.05）. In addition, in the experi- mental groups natural blood loss of 50% MAP and 30% MAP were significantly decreased （P 〈 0.05）. Conclusion TEAS can effectively speed up the recovery of blood pressure（60%MAP） and shorten the recovery time （50%, 40% MAP） in dogs, it also can reduce the blood loss in experiment at different degrees, so as to achieve the purpose of protection.