经皮穴位电刺激复合腰硬联合麻醉在下肢骨科手术中镇静镇痛应用观察

Observation of Transcutaneous Electrical Acupoint Stimulation Combined with Spinal Epidural Anesthesia to Treat the Sedation and Analgesia Used in Lower Limb Operation in Department of Orthopedics

目的:探究分析经皮穴位电刺激复合腰硬联合麻醉在下肢骨科手术中的镇静镇痛效果。方法:选择我院2013年3月—2014年5月收治的下肢骨科手术患者72例,在患者知情同意的情况下将其随机分为两组:即经皮穴位电刺激组与对照组各36例。对比分析两组患者腰硬联合麻醉后的临床效果。结果:经皮穴位电刺激组患者手术时间为(74.36±21.4)min,麻醉平面为(6.0±1.2)T,术中失血量为(118.6±2.7)m L,对照组患者手术时间为(76.12±19.5)min,麻醉平面为(6.0±0.9)T,术中失血量为(119.1±2.2)m L。两组患者麻醉平面、手术时间以及术中失血量情况对比差异不显著,无统计学意义(P=0.34,t=4.74)。两组患者在麻醉前以及手术开始时血压、心率、Sp O2、BIS等情况对比无显著差异(P=0.79,t=6.21);而在手术开始后半小时以及手术后,经皮穴位电刺激组患者的BIS较对照组明显降低(P=0.03,t=1.14)。经皮穴位电刺激组术后8 h以及术后24 h的VAS评分,与对照组相比明显更低,两组对比差异有统计学意义(P=1.26,t=6.03)。两组不良反应发生情况对比差异无统计学意义(P=0.35,t=5.27)。结论:经皮穴位电刺激复合腰硬联合麻醉在下肢骨科手术中能够起到较好的镇静镇痛效果,减少了镇痛药物的用量,且不良反应发生率较低。

Objective：To explore the analysis of transcutaneous electrical acupoint stimulation combined with spinal and epidural anesthesia in lower limb orthopedic surgery the sedative and analgesic effect. Methods：In our hospital March 2013 to 2014 admitted patients with lower limb orthopedic surgery in 72 cases,under informed consent to these patients were randomly divided into two groups,namely transcutaneous electrical acupoint stimulation group and control group with 36 cases in each group. Comparative analysis of the clinical effect of combined spinal epidural anesthesia in two groups after. Results：The transcutaneous electrical acupoint stimulation group,operation time for（74.36 ± 21.4） minutes,level of anesthesia（6.0±1.2）T,intraoperative blood loss was（118.6±2.7）m L. Patients in the control group,the operation time was（76.12±19.5）min,level of anesthesia（6.0±0.9）T,intraoperative blood loss was（119.1±2.2）m L. Two groups of anesthesia plane,operative time and blood loss volume compared no significant difference and no P=0.34,t=4.74 statistical significance. Contrast of two groups before anesthesia and surgery at the start of the blood pressure,heart rate,Sp O2,BIS and no significant difference（P=0.79,t=6.21）;and in half an hour after surgery and after surgery,transcutaneous electrical acupoint stimulation bis of patients were significantly lower than those of the control group（P=0.03,t=1.14）. Transcutaneous electrical acupoint stimulation group after eight hours and 24 hours after surgery VAS score,and compared to the control group were significantly lower,the differences between the two groups has statistical significance（P=1.26,t=6.03）. Two groups of adverse reactions compared with no significant difference（P=0.35,t=5.27）. Conclusion：The transcutaneous electrical acupoint stimulation combined spinal epidural anesthesia can play good effects of sedation and analgesia in lower limb orthopedic surgery and reduce the dosage of analgesic drugs and adverse reactions occur rate is low.