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河南大学附属南阳市第一人民医院麻醉科,南阳 473010
✉张彩举,主任医师。E-mail:zhangcaiju111@163.com
收稿:2024-02-23,
网络首发:2024-08-12,
纸质出版:2024-12-12
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周攀利, 张彩举, 周民涛, 等. 电针预处理对腹腔镜胃肠道肿瘤手术患者苏醒质量的影响[J]. 中国针灸, 2024,44(12):1377-1382.
ZHOU Panli, ZHANG Caiju, ZHOU Mintao, et al. Effect of electroacupuncture pretreatment on the quality of recovery in the patients undergoing laparoscopic gastrointestinal surgery[J]. Chinese Acupuncture & Moxibustion, 2024, 44(12): 1377-1382.
周攀利, 张彩举, 周民涛, 等. 电针预处理对腹腔镜胃肠道肿瘤手术患者苏醒质量的影响[J]. 中国针灸, 2024,44(12):1377-1382. DOI: 10.13703/j.0255-2930.20240223-k0001.
ZHOU Panli, ZHANG Caiju, ZHOU Mintao, et al. Effect of electroacupuncture pretreatment on the quality of recovery in the patients undergoing laparoscopic gastrointestinal surgery[J]. Chinese Acupuncture & Moxibustion, 2024, 44(12): 1377-1382. DOI: 10.13703/j.0255-2930.20240223-k0001.
目的:
2
观察电针预处理对腹腔镜胃肠道肿瘤手术患者苏醒质量的影响。
方法:
2
将60例择期于全身麻醉下行腹腔镜胃肠道肿瘤切除术患者随机分为观察组和对照组,每组30例。对照组采用常规静吸复合全身麻醉;在对照组基础上,观察组于麻醉诱导前30 min电针刺激双侧内关与内麻点30 min,采用疏密波,频率2 Hz/100 Hz。比较两组患者自主呼吸恢复时间、苏醒时间、拔管时间及麻醉恢复室(PACU)滞留时间,记录两组患者电针刺激前(T0)、拔管前(T1)、拔管即刻(T2)、拔管后5 min(T3)、拔管后10 min(T4)、出PACU(T5)平均动脉压(MAP)、心率(HR)及血氧饱和度(SpO
2
),观察两组患者T3、T4、T5疼痛视觉模拟量表(VAS)评分、Ramsay镇静评分,于T5评定两组躁动及恶心呕吐发生情况,检测两组患者T0、T5血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及皮质醇含量。
结果:
2
观察组患者自主呼吸恢复时间、苏醒时间、拔管时间及PACU滞留时间均短于对照组(
P
<
0.001)。观察组患者MAP、HR在T2时间点低于对照组(
P
<
0.01,
P
<
0.05)。观察组患者T3、T4、T5时间点疼痛VAS评分低于对照组(
P
<
0.001,
P
<
0.01);观察组患者T3时间点Ramsay镇静评分低于对照组(
P
<
0.05);观察组患者恶心呕吐发生率低于对照组(
P
<
0.05)。与T0时间点比较,两组患者血清TNF-α、IL-6及皮质醇含量在T5时间点升高(
P
<
0.001),观察组患者血清TNF-α、IL-6及皮质醇含量在T5时间点低于对照组(
P
<
0.01,
P
<
0.05)。
结论:
2
电针预处理能够提高腹腔镜胃肠道肿瘤手术患者麻醉苏醒质量,缩短自主呼吸恢复时间、苏醒时间、拔管时间及PACU滞留时间,减轻术后疼痛,降低应激反应。
Objective
2
To investigate the effect of electroacupuncture pretreatment on the quality of recovery in the patients undergoing laparoscopic gastrointestinal surgery.
Methods
2
Sixty patients for elective laparoscopic resection of gastrointestinal tumors under general anesthesia were randomly assigned to either an observation group or a control group
with 30 patients in each group. In the control group
the routine inhalation-intravenous combined general anesthesia was adopted. On the basis of the control group
in the observation group
30 min before anesthesia induction
electroacupuncture was applied to bilateral Neiguan (PC 6) and Neimadian (Extra) for 30 min
using disperse-dense wave and at 2 Hz/100 Hz. The recovery time of spontaneous breathing
awakening time
extubation time
and the post-anesthesia care unit (PACU) stay time were compared between the two groups. Mean arterial pressure (MAP)
heart rate (HR)
and oxygen saturation (SpO
2
) were recorded at multiple time points: before electroacupuncture (T0)
before extubation (T1)
immediately after extubation (T2)
5 minutes (T3) and 10 minutes (T4) after extubation
and upon discharge from PACU (T5). The visual analogue scale (VAS) score for pain and Ramsay sedation score at T3
T4 and T5 were observed; and the incidence of agitation
nausea and vomiting at T5 was evaluated in the two groups. At T0 and T5
the serum levels of tumor necrosis factor-alpha (TNF-α)
interleukin-6 (IL-6)
and cortisol were determined in the two groups.
Results
2
In the observation group
the recovery time of spontaneous breathing
awakening time
extubation time
and PACU stay time were shorter (
P
<
0.001)
MAP and HR at T2 were lower (
P
<
0.01
P
<
0.05)
the VAS scores for pain at T3
T4
and T5 drop
ped (
P
<
0.001
P
<
0.01)
and the Ramsay sedation score at T3 reduced (
P
<
0.05) compared with those in the control group. The incidence of nausea and vomiting was lower in the observation group when compared with that in the control group (
P
<
0.05). In comparison with the indexes at T0
the serum levels of TNF-α
IL-6
and cortisol increased at T5 in both groups (
P
<
0.01); and these indexes at T5 in the observation group were lower than those in the control group (
P
<
0.01
P
<
0.05).
Conclusion
2
Electroacupuncture pretreatment can enhance the quality of recovery in the patients undergoing laparoscopic gastrointestinal tumor surgery
shorten the time for spontaneous breathing recovery
awakening
extubation and PACU stay
and attenuate postoperative pain and stress response.
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