围术期电针刺激对腹腔镜手术的镇痛效果  

Analgesic effect of perioperative electroacupuncture stimulation on laparoscopic surgery

作　　者：甘英 王保 姚嘉茵[3] 尧新华 刘栋 黄蓉 鲁义 GAN Ying;WANG Bao;YAO Jiayin;YAO Xinhua;LIU Dong;HUANG Rong;LU Yi(Department of Anesthesiology,the Affiliated TCM Hospital of Guangzhou Medical University,Guangzhou 510130,China;Graduate School of Guangzhou Medical University,Guangzhou 511495,China;不详)

机构地区：[1]广州医科大学附属中医医院麻醉科,广州510130 [2]广州医科大学研究生院,广州511495 [3]中山大学附属第六医院消化内科,广州510655

出　　处：《实用医学杂志》2023年第20期2612-2617,共6页The Journal of Practical Medicine

基　　金：广东省自然科学基金面上项目(编号:2023A1515011117);广州市荔湾区科技计划项目(编号:20230712);广州市科技计划项目(编号:202201010712,2023A03J0310);广州医科大学附属中医医院重点项目(编号:2020ZD04);广州医科大学科研能力提升计划。

摘　　要：目的评估围术期电针刺激治疗全麻腹腔镜手术术后腹痛的疗效及安全性。方法采用随机数字表法将130例全麻腹腔镜手术的患者分为对照组和观察组。对照组用气管插管全麻麻醉完成手术。观察组于常规全麻麻醉的基础上,在麻醉前、术中各进行1次电针刺激治疗。分别比较两组术前、术后的数字评定量表(Numerical Rating Scale,NRS)评分、疼痛灾难化量表(Pain Catastrophizing Scale,PCS)评分、布雷格曼舒适量表(Bruggrmann Comfort Scale,BCS)评分、心率以及血压。此外,术后观察常见不良反应的发作情况,如皮肤出现瘙痒明显、红疹、恶心以及呕吐等。结果术后两组的活动NRS评分差异无统计学意义(P>0.05)。与对照组相比,观察组的静息状态NRS评分[(2.05±1.138)、(1.62±0.878),P=0.017]、PCS评分[(20.57±8.538)、(17.09±8.291),P=0.020]减少,BCS评分更高[(2.08±1.035)、(2.55±1.046),P=0.010],心率下降[(76.17±14.500)、(70.85±11.990),P=0.024]。观察组术后12、24小时收缩压相对对照组差异无统计学意义(P>0.05)。观察组手术后24 h收缩压较手术前下降[(125.6±15.725)、(123.60±16.781),P=0.040]。结论围术期电针刺激能缓解术后腹部疼痛,降低心率、血压,并未增加不良反应的发生。Objective To evaluate the therapeutic efficacy and safety of perioperative electroacupuncture on postoperative abdominal pain in patients undergoing general anesthesia laparoscopic surgery.Methods A total of 130 patients undergoing general anesthesia laparoscopic surgery were randomly divided into control group and experimental group.The control group received surgery under endotracheal intubation general anesthesia,while the experimental group received one session of electroacupuncture analgesia before and during anesthesia in addition to routine general anesthesia.The preoperative and postoperative pain Numerical rating scale(NRS),Pain Catastrophizing Scale(PCS),Bruggrmann comfort scale(BCS),heart rate,and blood pressure were compared between the two groups.The occurrence of common adverse reactions after surgery,such as significant itching,rash,nausea,and vomiting,was observed.Results No significant difference in activity NRS score was found between the two groups after surgery(P=0.618).Compared with the control group,the experimental group had lower resting NRS score[(2.05±1.138),(1.62±0.878),P=0.017],lower PCS score[(20.57±8.538),(17.09±8.291),P=0.020],and higher BCS score after surgery[(2.08±1.035),(2.55±1.046),P=0.010],and decreased heart rate[(76.17±14.500),(70.85±11.990),P=0.024].There was no significant difference in systolic blood pressure between the two groups 12 and 24 hours after surgery(P>0.05).A decrease in systolic blood pressure 24 hours after surgery was found in the experimental group when compared to that before surgery[(125.6±15.725),(123.60±16.781),P=0.040].Conclusion Perioperative electroacupuncture stimulation can relieve postoperative abdominal pain,reduce heart rate and blood pressure,but does not increase the occurrence of adverse reactions.

关 键 词：电针 围术期镇痛 术后疼痛 腹腔镜手术 

分 类 号：R614[医药卫生—麻醉学] R615[医药卫生—外科学] R246.2[医药卫生—临床医学]