经皮穴位电刺激对老年全麻围术期应激反应的影响

Effects of Transcutaneous Electrical Acupoint Stimulation on Stress Response and Analgesia Effects in Aged Patients under General Anesthesia

目的:观察经皮穴位电刺激(TEAS)对老年全身麻醉围术期应激反应和镇痛效果的影响。方法:全麻下行上腹部手术老年患者40例,随机分成对照组和观察组各20例,观察组从麻醉诱导前30 min持续行TEAS,麻醉诱导前(T0)、电刺激30 min(T1)、切皮(T2)、术中探查(T3)、术毕(T4)记录平均动脉血压(MAP)、心率(HR),采集外周静脉血样测血浆内皮素(ET)、皮质醇(Cor)含量。结果:两组患者T0的MAP、HR、ET、Cor无统计学差异(P>0.05);观察组MAP在T2(95.7±14.3)mm Hg、T3(96.2±15.4)mm Hg、T4(97.8±17.3)mm Hg与T0(93.6±14.3)mm Hg相比无统计学差异(P>0.05),与对照组同期相比下降(P<0.05);观察组HR在T2(86±12)次/min、T3(87±15)次/min与T0(75±12)次/min相比有统计学差异(P>0.05),与对照组同期相比降低(P<0.05);观察组ET在T2(74.2±7.1)ng/L、T3(72.8±8.1)ng/L、T4(69.8±7.6)ng/L与T0(70.9±8.1)ng/L相比无统计学差异(P>0.05),与对照组同期相比降低(P<0.05);观察组Cor在T2(375.2±93.5)nmol/L、T3(365.1±99.8)nmol/L、T4(370.4±102.5)nmol/L与T0(380.3±107.2)nmol/L相比无统计学差异(P>0.05),与对照组同期比较明显降低(P<0.05)。结论:经皮穴位电刺激能减轻老年全麻围术期应激反应,提供良好的镇痛效果。

Objective To explore the effects of transcutaneous electrical acupoint stimulation（TEAS） onstress response and analgesia in aged patients under general anesthesia.MethodsForty ASA I or II patientsundergoing elective operation for upper abdomen were randomly divided into 2 groups（n=20 each）： control groupand observation group. In observation group electrical stimulation of bilateral Hegu and Zusanli points werestarted from 30 min before induction of anesthesia and continued until the end of operation. Mean arterial pres-sure（MAP）, heart rate（HR）, and the contents of plasma endothelin（ET） and cortisol（Cor） were measured before an-esthesia（T0）, 30 min before electrical stimulation（T1）, after skin incision（T2）, during surgical explortion（T3）, andat the end of operation（T4）.ResultsThe indicators for MAP, HR, plasmic ET and plasmic Cor are not differ-ent at T0 in two groups. In observation group, MAP is（95.7 ± 14.3） mm Hg at T2,（96.2 ± 15.4） mm Hg. at T3,（97.8±17.3）mm Hg at T4. HR is（86±12） beats/min at T2,（87±15） beats/min at T3. Plasmic ET is（74.2±7.1） ng/L at T2,（72.8±8.1）ng/L at T3 and（69.8±7.6）ng/L at T4. The hemodynamic indicators（MAP and HR） are sig-nificantly different betweent two groups at T2 and T3. Similaly, plasmic ET and Cor are very different betweentwo groups at T2 and T3. Comparing to T0, plasmic ET and Cor are not different from those in T2,T3 and T4.ConclusionTranscutaneous electrical acupoint stimulation can reduce the stress response in aged patientsunder general anesthesia and provide good analgesic effect.