耳穴埋豆穴位按摩对腹腔镜胆囊切除术术中阿片类药物影响的临床观察

Clinical observation on the influence of auricular acupoint embedding acupoint massage on opioids during laparoscopic cholecystectomy

目的探究耳穴埋豆穴位按摩对腹腔镜胆囊切除术术中阿片类药物影响的效果。方法选取2018年1月至2019年12月本院收治的80例择期腹腔镜胆囊切除手术患者作为研究对象,随机分为对照组和观察组,每组40例。对照组采用全凭静脉麻醉,观察组采用全凭静脉麻醉联合耳穴埋豆穴位按摩。观察两组麻醉维持BIS(脑电双频指数)40~50,记录两组意识消失时丙泊酚(Marsh模型)和瑞芬太尼(Minto模型)药物的效应室浓度,probit分析术中丙泊酚和瑞芬太尼EC50和EC95的数值,并比较两组术中麻醉药物使用情况。结果观察组意识消失时瑞芬太尼效应室浓度、丙泊酚效应室浓度均低于对照组(P<0.05)。观察组术中维持丙泊酚和瑞芬太尼EC50和EC95值均低于对照组,差异有统计学意义(P<0.05)。结论全凭静脉麻醉联合耳穴埋豆穴位按摩可有效减少腹腔镜胆囊切除术术中阿片类药物及其他麻醉药物的使用剂量。

Objective To explore the effect of auricular acupoint embedding acupoint massage on opioids during laparoscopic cholecystectomy.Methods 80 patients undergoing elective laparoscopic cholecystectomy in our hospital from January 2018 to December 2019 were selected as the re-search subjects,and they were randomly divided into control group and observation group,with 40 cases in each group.The control group used total intravenous anesthesia,and the observation group used total intravenous anesthesia combined with auricular acupoint embedding acupoint massage.The anesthesia to maintain BIS(Bispectral Index)40-50 between the two groups were observed,record the effect room concentrations of propofol(Marsh model)and remifentanil(Minto model)during loss of consciousness between the two groups were recorded,and the values of EC50 and EC95 of propofol and remifentanil during operation were analyzed by probit analysis.The use of anesthetics during the operation was compared between the two groups.Results The concentration of remifentanil and propofol in the observation group were lower than those in the control group(P<0.05).The EC50 and EC95 values of propofol and remifentanil in the observation group were lower than those in the control group,the difference was sta-tistically significant(P<0.05).Conclusion Total intravenous anesthesia combined with auricular acupoint embedding acupoint massage can effec-tively reduce the dosage of opioids and other anesthetics during laparoscopic cholecystectomy.