穴位电刺激对全身麻醉气管插管术后咽喉痛的防治作用  

Effects of transcutaneous electrical acupoint stimulation on treatment and prevention of postoperative sore throat after tracheal intubation under general anesthesia

作　　者：王冬冬[1] 马婷婷[1] 李国政[1] 范珊珊[1] 

机构地区：[1]浙江省立同德医院麻醉科,杭州310012

出　　处：《中国针灸》2017年第7期701-704,共4页Chinese Acupuncture & Moxibustion

基　　金：浙江省中医药科学研究基金项目:2015ZB011

摘　　要：目的:观察合谷和内关穴经皮穴位电刺激(TEAS)防治全身麻醉气管插管术后咽喉痛(POST)的临床疗效。方法:将美国麻醉医师协会(ASA)病情分级Ⅰ~Ⅱ级、择期甲状腺腺叶切除的100例患者,采用随机数字表法分为TEAS辅助全麻组(观察组)和常规全麻组(对照组),每组50例。两组患者均选择气管插管全身麻醉,其中观察组患者麻醉诱导前30 min至术毕辅以合谷和内关穴TEAS进行干预(2 Hz/100 Hz的疏密波、电流强度介于8~12 m A),对照组也以相同的装置在患者双侧合谷和内关穴但并不行电刺激,分别记录两组患者拔管后1、6、12、24 h各时点POST发生率、严重程度及疼痛视觉模拟量表(VAS)评分。结果:观察组拔管后1、6、12 h各时点POST发生率分别为12.0%(6/50)、22.0%(11/50)、18.0%(9/50),均显著低于相应时间点对照组POST的发生率(分别为30.0%(15/50)、42.0%(21/50)、36.0%(18/50),均P<0.05),而拔管后24 h,两组患者POST发生率比较差异无统计学意义[14.0%(7/50) vs 28.0%(14/50),P>0.05];观察组出现POST患者拔管后1、6、12、24 h各时点POST的VAS评分均显著低于对照组(均P<0.05)。结论:全身麻醉气管插管术中辅以合谷穴和内关穴TEAS干预,可有效降低POST的发生率及严重程度。Objective To observe the clinical efficacy of transcutaneous electrical acupoint stimulation（TEAS） at Hegu（LI 4） and Neiguan（PC 6） on treatment and prevention of postoperative sore throat（POST） after tracheal intubation under general anesthesia. Methods One hundred patients who received elective thyroid gland lobectomy with gradeⅠand Ⅱ of American Society of Anesthesiologists criteria were randomly assigned into a TEAS group and an anesthesia group according to random number table method, 50 cases in each group. All the patients were treated with tracheal intubation under general anesthesia. Patients in the TEAS group were treated with TEAS（2 Hz/100 Hz, 8 to 12 m A） at Hegu（LI 4） and Neiguan（PC 6） from 30 min before anesthesia induction to the end of operation. Patients in the anesthesia group were treated with TEAS at the same acupoints but no electrical stimulation was given. The incidence rate, severity and visual analogue scale（VAS） of POST were recorded 1 h, 6 h, 12 h and 24 h after tracheal extubation, respectively. Results The incidence rate of POST was 12.0%（6/50）, 22.0%（11/50） and 18.0%（9/50） 1 h, 6 h, 12 h after tracheal extubation respectively in the TEAS group, which was significantly lower than 30.0%（15/50）, 42.0%（21/50） and 36.0%（18/50） in the anesthesia group（all P〈0.05）. However,the incidence rate was not significantly different between the two groups 24 h after extubation [14.0%（7/50） vs 28.0%（14/50）, P〈0.05]. Moreover, the VAS scores of the patients with POST in the TEAS group at each time point were lower than those in the anesthesia group（all P〈0.05）. Conclusion TEAS at Hegu（LI 4） and Neiguan（PC 6） can effectively reduce the incidence rate and severity of POST induced by tracheal intubation under general anesthesia.

关 键 词：经皮穴位电刺激 全身麻醉 气管插管 术后咽喉痛 

分 类 号：R246.2[医药卫生—针灸推拿学]