经皮穴位电刺激对开颅术丙泊酚靶控输注全麻效能的影响  

Effect of Transcutaneous Acupoint Electrical Stimulation Combined with Target Controlled Infusion of Propofol on Efficacy of General Anesthesia for Craniotomy

作　　者：吴群[1] 张明晓[1] 王璐璐[1] 莫云长[1] 戴勤学[1] 王丹丹[1] 王均炉[1] 

机构地区：[1]温州医学院附属第一医院麻醉科,温州325000

出　　处：《针刺研究》2013年第3期229-233,共5页Acupuncture Research

基　　金：国家重点基础研究发展计划("973"计划)项目(No.2013CB 531900);温州市科技计划项目(Y 20100328)

摘　　要：目的:观察经皮穴位电刺激(TAES)对开颅手术全麻中丙泊酚用量、苏醒时间及拔管时间的影响。方法:择期开颅手术患者40例,随机分为观察组(20例)和对照组(20例),两组均采用以丙泊酚靶控输注为主的全凭静脉麻醉,观察组加用TAES干预。穴位选择鱼腰、太阳、合谷及颧髎、风池,采用LH 402韩氏经皮穴位刺激仪行TAES诱导并维持到手术结束。两组均记录麻醉时间、手术时间、苏醒时间、拔管时间及术中丙泊酚、芬太尼、维库溴铵及血管活性药物用量。结果:术中丙泊酚平均所需量观察组较对照组减少21.1%,观察组较对照组患者术中尼卡地平平均所需量减少45.7%,差异均具有统计学意义(P<0.05)。观察组苏醒时间、拔管时间较对照组减少(P<0.05)。两组患者围术期芬太尼及维库溴胺用量差异无统计学意义(P>0.05)。结论:TAES与丙泊酚靶控输注全麻联合应用,可减少开颅手术中丙泊酚用量,且可缩短苏醒时间及拔管时间。Objective To observe the effect of transcutaneous acupoint electrical stimulation （TAES） combined with target controlled infusion of Propofol on the doses of Propofol and adjuvant drugs, and on the resuscitation time of general anesthe- sia for craniotomy patients. Methods Forty patients （aged 27 - 65 years）, scheduled for craniotomy and signed the informed consent, were randomly and equally divided into TAES group and control group. Patients of the two groups received intravenous anesthesia mainly with target controlled infusion of Propofol. TAES （2 Hz/100 Hz, 1 - 12 mA） was applied to bilateral Yuyao （EX- HN 4） and Taiyang （EX-HN 5） for 20 min first before surgery, and then to bilateral Hegu （LI 4）, Quanliao （S118） and Fengchi （GB 20） during operation and till the end of the operation. The dosages of Propofol and adjuvant drugs, the duration of surgery and ane- sthesia, and the time of resuscitation and extubation were recorded. Results Oompared with the control group, the dosages of Propofol and Nicardipine for craniotomy patients in the TAES group were significantly lower （ P〈0.05）, and the resuscitation time was obviously earlier and the tracheal catheter indwelling time markedly shorter in the TAES group （P〈0.05）. Conclusion TAES combined with target controlled infusion of Propofol can reduce the dosage of Propofol and Nicardipine, and shorten the re- suscitation time and tracheal catheter indwelling time in craniotomy patients.

关 键 词：经皮穴位电刺激 颅脑手术 丙泊酚 麻醉 

分 类 号：R246.2[医药卫生—针灸推拿学]