经皮穴位电刺激辅助全凭静脉麻醉用于甲状腺切除术的临床效果

Clinical efficacy of percutaneous electrical acupoint stimulation in assisting total intravenous anesthesia for thyroidectomy

目的观察经皮穴位电刺激辅助全凭静脉麻醉用于甲状腺切除术的临床效果。方法全凭静脉麻醉下行甲状腺切除术患者60例随机均分为两组。于麻醉诱导前30min至手术结束,A组行经皮穴位电刺激双侧合谷穴和内关穴,B组未行经皮穴位电刺激为对照,两组麻醉诱导与维持均采用全凭静脉麻醉,术中维持脑电双频指数40~60。记录术中丙泊酚和瑞芬太尼输注速度,比较两组围麻醉期MAP和HR变化,观察术后24h内恶心呕吐发生情况。结果与B组比较,A组术中丙泊酚和瑞芬太尼输注速度降低[(182.00±6.72)mg/h vs.(245.00±10.64)mg/h和(0.43±0.05)mg/h vs.(0.65±0.06)mg/h](P<0.05)。与B组同时间点比较,A组麻醉诱导时MAP和HR均升高,而手术切皮时MAP和HR均降低(P<0.05)。与B组比较,A组术后24h内恶心呕吐发生次数减少[(1.2±0.4)次/时vs.(3.8±0.6)次/时](P<0.05)。结论经皮穴位电刺激辅助全凭静脉麻醉用于甲状腺切除术疗效好,可维持术中循环稳定,减少麻醉药物用量和不良反应发生。

Objective To observe the clinical efficacy of percutaneous electrical acupoint stimulation in assisting total intravenous anesthesia for thyroidectomy.Methods Sixty patients undergoing thyroidectomy under total intravenous anesthesia were randomly divided into two groups with 30cases each.At 30minutes before anesthesia induction till the end of operation,percutaneous electrical acupoint stimulation of both sides acupoints of Hegu and Neiguan was performed in group A,percutaneous electrical acupoint stimulation was not performed in group B as control.Both groups received total intravenous anesthesia for induction and maintenance and bispectral index was maintained in 40-60during surgery.The intraoperative infusion speed of propofol and remifentanil was recorded,the changes of perioperative MAP and HR were compared between two groups,and the incidence of nausea and vomiting within 24hours after surgery was observed.Results Compared with group B,intraoperative infusion rate of propofol and remifentanil decreased in group A[(182.00±6.72)mg/h vs.(245.00±10.64)mg/h and(0.43±0.05)mg/h vs.(0.65±0.06)mg/h](P<0.05).Compared with group B at the same time point,MAP and HR at anesthesia induction were increased,while MAP and HR at surgical incision were decreased in group A(P<0.05).Compared with group B,the times of nausea and vomiting within 24hours after surgery was reduced in group A[(1.2±0.4)times per hours vs.(3.8±0.6)times per hours](P<0.05).Conclusion Percutaneous electrical acupoint stimulation in assisting total intravenous anesthesia for thyroidectomy has a good effect,can maintain stability of intraoperative circulation,reduce amount of anesthetic drugs and adverse reactions.