Objective: To explore the effect of electroacupuncture (EA) on the transplanted kidney function during operation and in the early period of post operation. Methods: Forty four adult patients (22 males and 22 females) ...Objective: To explore the effect of electroacupuncture (EA) on the transplanted kidney function during operation and in the early period of post operation. Methods: Forty four adult patients (22 males and 22 females) were randomized to one of the following four groups (with 11 patients in each group): ①routine dose (12～14 mL) epidural block (RDEB), ②small dose (7～8 mL) epidural block (SDEB), ③ EA+RDEB and ④ EA+SDEB. Patients in the two EA group received a 30 minutes’ EA stimulation of Ciliao (BL 32), Sanyinjiao (SP 6), Taixi (KI 3) and Zusanli (ST 36) before epidural anesthesia. Additional epidural doses were permitted to maintain a block level of T 6～T 8 whenever necessary during operation. Lactate Linger’s solution and 5% dextrose were infused intravenously. Colloids or blood transfusion was used if indicated. The ECG, SPO 2, arterial blood pressure and respiratory rate were monitored continuously. Plasma epinephrine (E) and norepinephrine (NE) were detected before anesthesia and at the time of restoration of renal blood flow to the transplanted kidney. The time for starting urine formation and urine flow rate were recorded. Hemodynamic parameters, urine output, solution input, plasma urea, creatinine and potassium were monitored daily postoperatively for 4 days. Results: ① Mean consumptions of local anesthetic solution were 28, 24, 21 and 14 mL in RDEB, SDEB, EA+RDEB and EA+SDEB groups respectively. ② Hemodynamics was more stable in EA+SDEB group with minimum intravenous solution requirement. ③ Earlier urine formation and more urine output were found in patients of the two EA groups in comparison with RDEB and SDEB groups. ④ There were no statistically significant changes in plasma NE levels between pre and post operation in the 4 groups while plasma E levels in two EA groups were higher than preoperation. ⑤ Hemodynamics was maintained stable in all groups postoperatively. ⑥ Urine output in SDEB was less than those of the other groups in the first 24 hours of postoperation and was still less than that of RDEB group in the following 24 hours after operation. ⑦ Plasma urea, creatinine and potassium decreased faster in two EA groups. Conclusion: Electroacupuncture stimulation can decrease the requirement of epidural anesthetics, increase plasma epinephrine level, stabilize hemodynamics and improve the early renal function of the transplanted kidney under combined anesthesia of EA and epidural administration of small dose of anesthetics.展开更多
文摘Objective: To explore the effect of electroacupuncture (EA) on the transplanted kidney function during operation and in the early period of post operation. Methods: Forty four adult patients (22 males and 22 females) were randomized to one of the following four groups (with 11 patients in each group): ①routine dose (12～14 mL) epidural block (RDEB), ②small dose (7～8 mL) epidural block (SDEB), ③ EA+RDEB and ④ EA+SDEB. Patients in the two EA group received a 30 minutes’ EA stimulation of Ciliao (BL 32), Sanyinjiao (SP 6), Taixi (KI 3) and Zusanli (ST 36) before epidural anesthesia. Additional epidural doses were permitted to maintain a block level of T 6～T 8 whenever necessary during operation. Lactate Linger’s solution and 5% dextrose were infused intravenously. Colloids or blood transfusion was used if indicated. The ECG, SPO 2, arterial blood pressure and respiratory rate were monitored continuously. Plasma epinephrine (E) and norepinephrine (NE) were detected before anesthesia and at the time of restoration of renal blood flow to the transplanted kidney. The time for starting urine formation and urine flow rate were recorded. Hemodynamic parameters, urine output, solution input, plasma urea, creatinine and potassium were monitored daily postoperatively for 4 days. Results: ① Mean consumptions of local anesthetic solution were 28, 24, 21 and 14 mL in RDEB, SDEB, EA+RDEB and EA+SDEB groups respectively. ② Hemodynamics was more stable in EA+SDEB group with minimum intravenous solution requirement. ③ Earlier urine formation and more urine output were found in patients of the two EA groups in comparison with RDEB and SDEB groups. ④ There were no statistically significant changes in plasma NE levels between pre and post operation in the 4 groups while plasma E levels in two EA groups were higher than preoperation. ⑤ Hemodynamics was maintained stable in all groups postoperatively. ⑥ Urine output in SDEB was less than those of the other groups in the first 24 hours of postoperation and was still less than that of RDEB group in the following 24 hours after operation. ⑦ Plasma urea, creatinine and potassium decreased faster in two EA groups. Conclusion: Electroacupuncture stimulation can decrease the requirement of epidural anesthetics, increase plasma epinephrine level, stabilize hemodynamics and improve the early renal function of the transplanted kidney under combined anesthesia of EA and epidural administration of small dose of anesthetics.
