电针预处理对腹腔镜全子宫切除术患者苏醒期躁动的影响  

Effect of electroacupuncture preconditioning on emergence agitation in patients undergoing total laparoscopic hysterectomy

作　　者：周民涛 张彩举[1] 付金厚[1] 何金乾[1] 齐倩颖 孙宁[1] 张碧潭 Zhou Mintao;Zhang Caiju;Fu Jinhou;He Jinqian;Qi Qianying;Sun Ning;Zhang Bitan(Department of Anesthesia and Perioperative Medicine,Nanyang First People′s Hospital Affiliated to Henan University,Nanyang 473010,China)

机构地区：[1]南阳市第一人民医院,河南大学附属医院麻醉与围术期医学科,南阳473010

出　　处：《中华麻醉学杂志》2024年第11期1307-1310,共4页Chinese Journal of Anesthesiology

基　　金：河南省医学科技攻关计划项目(LHGJ20221045)。

摘　　要：目的评价电针预处理对腹腔镜全子宫切除术患者苏醒期躁动的影响。方法本研究为随机对照试验。择期拟行腹腔镜全子宫切除术患者90例,年龄40~60岁,体质量50~70 kg,ASA分级Ⅱ或Ⅲ级,采用随机数字表法分为对照组(C组)和电针预处理组(E组),每组45例。麻醉诱导前30 min,E组电针刺激足三里穴和内关穴,疏密波,频率2/100 Hz,电流强度3 mA,刺激时间30 min;C组不予电针刺激。记录2组患者苏醒期躁动的发生情况;记录2组患者血管活性药物使用及镇痛补救情况;于电针刺激前(T0)和术后2 h(T1)时抽取上肢外周静脉血,采用ELISA法测定血浆CRP、TNF-α和IL-10的浓度。结果与T0时比较,T1时C组血浆CRP、TNF-α浓度和E组血浆IL-10浓度升高(P<0.05);与C组比较,E组血管活性药物使用率、镇痛补救率和苏醒期躁动发生率降低,T1时血浆CRP和TNF-α浓度降低,血浆IL-10浓度升高(P<0.05)。结论电针预处理可降低腹腔镜全子宫切除术患者苏醒期躁动的发生,可能与其抑制炎症反应有关。Objective To evaluate the effect of electroacupuncture preconditioning on emergence agitation in the patients undergoing total laparoscopic hysterectomy.Methods This was a randomized controlled trial.Ninety American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ patients,aged 40-60 yr,with a body mass index of 50-70 kg,scheduled for elective total laparoscopic hysterectomy,were divided into control group(C group)and electroacupuncture preconditioning group(E group)using a random number table method,with 45 patients in each group.At 30 min before anesthesia induction,Zusanli and Neiguan acupoints were stimulated for 30 min with disperse-dense waves at a frequency of 2 Hz/100 Hz,an intensity of 3 mA,in group E.Group C did not receive electroacupuncture treatment.The occurrence of emergence agitation,usage of vasoactive drugs and rescue analgesia were recorded in two groups.Peripheral venous blood samples from the upper extremity were obtained before electroacupuncture stimulation(T 0)and at 2 h after operation(T 1)for determination of the plasma concentrations of C-reactive protein(CRP),tumor necrosis factor-alpha(TNF-α)and interleukin-10(IL-10)by enzyme-linked immunosorbent assay.Results The plasma CRP and TNF-α concentrations in group C and plasma IL-10 concentrations in group E were significantly higher at T 1 than at T 0(P<0.05).Compared with group C,the usage rate of vasoactive drugs,rate of rescue analgesia,and incidence of emergence agitation were significantly decreased,and the plasma concentrations of CRP and TNF-αwere decreased and the plasma IL-10 concentrations were increased at T 1 in group E(P<0.05).Conclusions Electroacupuncture preconditioning can decrease the occurrence of emergence agitation in the patients undergoing total laparoscopic hysterectomy,which may be related to inhibiting inflammatory responses.

关 键 词：电针 腹腔镜 子宫切除术 苏醒期躁动 

分 类 号：R246.2[医药卫生—针灸推拿学]