穴位持续经皮电刺激对肺癌手术麻醉药物用量、麻醉恢复质量的影响
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R614.2;734.2

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Effect of Continuous Transcutaneous Electrical Point Stimulation on Dosage of Anesthesia Drugs and Quality of Anesthesia Recovery During Lung Cancer Surgery
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    摘要:

    目的:观察持续经皮电刺激合谷、内关和足三里穴在肺癌手术辅助麻醉中的应用效果。方法:将 行全身麻醉下肺癌根治术患者103例随机分为观察组52例与对照组51例。2组均在常规麻醉下行肺癌根治术治 疗。麻醉期间观察组取双侧合谷、内关和足三里穴,予以持续经皮电刺激治疗;对照组在相应穴位放置电极 片,但无电流刺激。比较2组围手术期[麻醉诱导前10 min (T0)、切皮时(T1)、打开胸膜腔时(T2)、术毕 时(T3)、完全苏醒时(T4) ]血流动力学指标[心率(HR)、平均动脉压(MAP) ]、术中麻醉药物用量、术后麻 醉恢复质量、疼痛情况[疼痛视觉模拟评分法(VAS) 评分]及不良反应发生情况。结果:T0~T4时间点,2组 HR、MAP比较,差异均无统计学意义(P>0.05)。观察组丙泊酚、瑞芬太尼用量低于对照组(P<0.05);2组 舒芬太尼、苯磺顺阿曲库铵用量比较,差异均无统计学意义(P>0.05)。观察组术毕至苏醒时间、拔管时间、 下床活动时间、肛门排气时间均短于对照组(P<0.05),术后24 h的40项术后恢复质量量表(QoR-40) 评分 高于对照组(P<0.05)。术后6 、12 、24 h,观察组VAS评分均低于对照组(P<0.05);术后48 h ,2组VAS 评分比较,差异无统计学意义(P>0.05)。48 h内观察组镇痛泵按压次数少于对照组(P<0.05)。术后,观察 组不良反应总发生率为7.69%,对照组为29.41%,2组比较,差异有统计学意义(P<0.05)。结论:持续经皮 电刺激合谷、内关和足三里穴可减少肺癌手术中麻醉药物用量、提高麻醉恢复质量,且有利于减轻术后疼痛、 减少麻醉所带来的不良反应。

    Abstract:

    Abstract: Objective: To observe the application effect of continuous transcutaneous electrical stimulation at Hegu point (LI 4), Neiguan point (PC 6), and Zusanli point (ST 36) on supplemental anesthesia for lung cancer surgery. Methods:A total of 103 cases of patients undergoing radical surgery for lung cancer under general anesthesia were randomly divided into the observation group and the control group,with 52 and 51 cases in each group respectively. The lung cancer radical surgery in the two groups was performed under conventional anesthesia. During anesthesia, the observation group was given continuous transcutaneous electrical stimulation at Hegu point (LI 4), Neiguan point (PC 6), and Zusanli point (ST 36) on the two sides. In the control group,electrodes were placed at the corresponding points, but without electrical stimulation. Hemodynamics [heart rate (HR) and mean arterial pressure (MAP)], intraoperative anesthetic dosage, postoperative anesthesia recovery quality, pain situation (VAS score), and incidence of adverse reactions were compared between two groups during the perioperative period [10 minutes before anesthesia induction (T0), skin incision (T1), pleural cavity opening (T2), surgery completion (T3), and complete awakening (T4)]. Results: There was no significant difference in the comparison of HR and MAP between the two groups during T0-T4 (P>0.05). Dosage of Propofol and Remifentanil in the observation group was lower than that in the control group (P<0.05); there was no significant difference in the comparison of dosage of Sufentanil and Cisatracurium Besilate between the two groups (P>0.05). The postoperative recovery time,extubation time,out-of-bed time,and anal exhaust time in the observation group were shorter than those in the control group (P<0.05). The scores of 40-item Quality of Recovery Questionnaire (QoR-40) 24 hours after surgery in the observation group were higher than those in the control group (P<0.05). At 6,12,and 24 hours postoperatively,the VAS scores in the observation group were lower than those in the control group (P<0.05);there was no significant difference in VAS scores between the two groups 48 hours after surgery (P>0.05). The number of pressing of the analgesic pump within 48 hours in the observation group was less than that in the control group (P<0.05). After surgery, the incidence of adverse reactions was 7.69% in the observation group and 29.41% in the control group, the difference being significant (P<0.05). Conclusion: During lung cancer surgery, continuous transcutaneous electrical stimulation at Hegu point (LI 4), Neiguan point (PC 6), and Zusanli point (ST 36) can reduce the dosage of anesthetic drugs,improve the quality of anesthesia recovery,and conduce to relieve postoperative pain and reduce adverse reactions to anesthesia.

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郑雪梅,黄仁微,章吕霞.穴位持续经皮电刺激对肺癌手术麻醉药物用量、麻醉恢复质量的影响[J].新中医,2024,56(8):165-170

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  • 在线发布日期: 2024-04-23
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