围术期应用经皮穴位电刺激对胸腔镜肺叶切除术患者镇痛效果及HR、SBP、DBP、MAP的影响  

Application of transcutaneous acupoint electrical stimulation during the perioperative period on the analgesic effect and the effects of HR,SBP,DBP,and MAP in patients undergoing thoracoscopic lobectomy

作　　者：刘晋敏 张朋 邓方方 祝德刚 LIU Jinmin;ZHANG Peng;DENG Fangfang;ZHU Degang(Anesthesiology Department,Wuhan No.1 Hospital,Wuhan,Hubei,China,430000)

机构地区：[1]武汉市一医院麻醉科,湖北武汉430000

出　　处：《分子诊断与治疗杂志》2024年第11期2144-2147,2151,共5页Journal of Molecular Diagnostics and Therapy

基　　金：武汉市医学科研项目(FZ2022020)。

摘　　要：目的研究围术期应用经皮穴位电刺激(TEAS)对胸腔镜肺叶切除术(VATS)患者镇痛效果及心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)的影响。方法将武汉市一医院2023年1月至2023年6月收治的98例VATS患者用简单随机化法分为TEAS组、对照组,每组49例。TEAS组患者手术30 min前进行经皮穴位电刺激,对照组不进行电刺激,两组麻醉方案一致。比较两组的手术情况、镇痛效果、血流动力学、术后恢复、不良反应。结果TEAS组舒芬太尼、瑞芬太尼、丙泊酚剂量显著低于对照组,差异有统计学意义(t=9.504、4.632、10.512,P<0.05);两组术后48 h视觉模拟评分法(VAS)评分较24 h VAS评分降低,TEAS组患者术后24 h、48 h时的VAS评分及48 h内镇痛泵按压次数均显著低于对照组,差异有统计学意义(t=16.027、21.472、15.502,P<0.05);两组T_(0)、T_(1)、T_(2)、T_(3)4个时间点的HR(t=1.879、1.019、0.054、0.982)、SBP(t=0.323、0.856、1.217、0.363)、DBP(t=0.474、0.315、0.632、0.452)、MAP(t=0.423、1.728、1.609、0.472)组间差异无统计学意义(P>0.05);与对照组相比,TEAS组患者术后苏醒时间、术后住院时间都缩短,开始下地活动时间缩短,差异有统计学意义(t=10.718、4.778、11.310,P<0.05);TEAS组术后48 h内不良反应总发生率低于对照组(χ^(2)=4.009、P<0.05)。结论TEAS能够减少VATS患者麻醉药物使用的剂量,减轻患者的疼痛,降低术后不良反应风险,促进患者术后康复。Objective To study the impact of applying transcutaneous electrical acupoint stimulation(TEAS)in the perioperative period on analgesic effect,heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP)and mean arterial pressure(MAP)of patients undergoing thoracoscopic lobectomy.Methods A total of 98 patients who underwent thoracoscopic lobectomy at Wuhan No.1 Hospital from January to June 2023 were randomly divided into two groups:the TEAS group and the control group,each consisting of 49 cases.The TEAS group received TEAS 30 minutes before surgery,while the control group did not receive any electrical stimulation.Both groups received the same anesthesia.Surgical conditions,analgesic effects,hemodynamics,postoperative recovery,and adverse reactions were compared between the two groups.Results The dosages of sufentanil,remifentanil,and propofol in the TEAS group were lower than those in the control group,and the differences were statistically significant(t=9.504,4.632,10.512,P<0.05).The Visual Analogue Scale(VAS)scores of both groups were lower at 48 hours after surgery than 24 hours after surgery.VAS scores at 24 hours and 48 hours after surgery,and the times of analgesic pump pressing within 48 hours in TEAS group were lower than those in the control group,with statistically significant differences(t=16.027,21.472,15.502,P<0.05).At T_(0),T_(1),T_(2) and T_(3),there were no statistically significant differences between groups in terms of HR(t=1.879,1.019,0.054,0.982),SBP(t=0.323,0.856,1.217,0.363),DBP(t=0.474,0.315,0.632,0.452),and MAP(t=0.423,1.728,1.609,0.472)(P>0.05).Compared with the control group,there were decreases in postoperative recovery time,hospital stay and time to off-bed activities in the TEAS group,and the differences were statistically significant(t=10.718,4.778,11.310,P<0.05).The total incidence of adverse reactions within 48 hours after surgery in the TEAS group was lower than that in the control group(χ^(2)=4.009,P<0.05).Conclusion TEAS can reduce the dosage of anesthetic drugs

关 键 词：经皮穴位电刺激 胸腔镜手术 疼痛 

分 类 号：R614[医药卫生—麻醉学]