经皮穴位电刺激对行开颅术的老年患者全麻拔管期应激反应的影响

Effects of Transcutaneous Electrical Acupoint Stimulation on Stress Response During Extubation in Elderly Patients Undergoing Brain Surgery

目的:观察经皮穴位电刺激(TEAS)对行开颅术的老年患者全麻拔管期应激反应的影响。方法:60例行开颅术的老年患者,随机分为经皮穴位电刺激(TEAS)组,假电刺激(Sham)组,TEAS组患者从麻醉诱导前30min持续行TEAS,Sham组患者不做任何处理。记录麻醉诱导前(T0)、手术结束时(T1)、拔管后即刻(T2)以及拔管后5 min、10 min(T3,T4)两组的血压(NIBP)、平均动脉压(MAP)、心率(HR),静脉血中肾上腺素(E)、去甲肾上腺素(NE)的浓度以及术后不良反应的发生情况。结果:与Sham组比较,TEAS组患者在T2、T3、T4时的NIBP、MAP、HR,静脉血中的E、NE的浓度以及术后不良反应的发生率均降低(P<0.05)。结论:经皮穴位电刺激能抑制行开颅术的老年患者全麻拔管期的应激反应。

Objective：To investigate whether transcutaneous electrical acupoint stimulation （TEAS） could decrease the stress response during extubation in elderly patients after brain surgery. Methods ：60 elderly patients scheduled for brain surgery were randomly divided into TEAS and Sham groups. 30 mins prior to the induction of anesthesia, patients in TEAS group were given electrical stimulation which lasted to 5mins before the end of the surgery; patients in Sham group were lefted untreated. Recored the noninvasive blood pressue （ NIBP）, mean arterial pressure （ MAP）, heart rate （HR）, and the plasma concentrations of Epinephrine （E）, Norepinephrine （NE） at the time points of prior to the induction （TO） ; at the end of surgery （ T1 ） ; immediately after extubation （T2） ; and at 5 and 10mins after extubation （ T3 and T4）. Results ： Compared with patients in Sham group, the NIBP, MAP, HR were lower at T2 - T4, as well as the plas- ma concentrations of E, NE （ P 〈 0.05 ）. Furthermore, the incidence of postoperative complications was also lower （ P 〈 0. 05 ）. Comclusion ：TEAS could decrease the stress response during extubation in elderly patients undergoing brain surgery.