摘要
目的探讨穴位电针刺激对全身麻醉下行后路腰椎椎间融合术(posterior lumbar interbody fusion,PLIF)患者术中麻醉药用量及术后恶心、呕吐的辅助作用。方法选择择期行PLIF术的患者78例,年龄18～59岁,随机分为3组,每组26例。3组均行全凭静脉麻醉。A组(全凭静脉麻醉组)、B组(在A组基础上复合百会、四神聪、双侧内关电针刺激)、C组(在B组基础上复合双侧合谷、足三里电针刺激)。B组、C组患者均于手术前1天、麻醉诱导前30min给予相应穴位电针刺激。记录3组患者术中丙泊酚、瑞芬太尼、舒芬太尼、苯磺顺阿曲库铵用药量,患者入室、切皮、上内固定、拔管、离室时的平均动脉压(MAP)、心率(HR)、指脉氧饱和度(SpO2),术后第1天视觉模拟量表(visual analogue scale,VAS)评分以及恶心、呕吐发生情况。结果 3组各剔除1例。B组、C组瑞芬太尼用量少于A组(P<0.05),B组与C组间比较差异无统计学意义(P>0.05);3组患者丙泊酚、舒芬太尼、苯磺顺阿曲库胺用量以及术后第1天VAS评分差异均无统计学意义(P均>0.05)。3组患者入室、切皮、上内固定、拔管、离室时的MAP、HR和SpO2组间和组内比较差异均无统计学意义(P均>0.05)。B组、C组恶心、呕吐发生比例均少于A组(P<0.05)。结论全凭静脉麻醉复合百会、四神聪、双侧内关电针刺激可以减少全麻患者术中瑞芬太尼用药量及术后恶心、呕吐的发生。
Objective To explore the auxiliary role of acupoint electroacupuncture(EA)stimulation on intraoperative anesthetic dosage and postoperative nausea and vomiting in patients with posterior lumbar interbody fusion under general anesthesia.Methods Total 78 patients were selected,aged from 18 to 59,randomly divided into 3 groups,with 26 cases in each group.All three groups were given total intravenous anesthesia.Group A(total intravenous anesthesia),group B(on the basis of group A,compound baihui,sishencong,bilateral neiguan electroacupuncture stimulation),group C(on the basis of group B,compound bilateral hegu and zusanli electroacupuncture stimulation).In group B and C,EA stimulation was administered one day before the operative and 30 minutes before induction of anesthesia.The intraoperative dosage of propofol,remifentanil,sufentanil and cisatracurium besylate,mean arterial pressure(MAP),heart rate(HR),finger oxygen saturation(SpO2)at admission,skin incision,internal fixation,extubation and departure were recorded.The visual analogue scale(VAS)score and the incidence of nausea and vomiting on the first day after operation were recorded.Results One case was eliminated in each group.The dosage of remifentanil in group B and group C was less than that in group A(P<0.05),and there was no statistically significant difference between group B and group C(P >0.05).There was no statistically significant difference in the doses of propofol,sufentanil and benzalsudosutrascumide between the three groups as well as the VAS(visual analogue scale)score on the first day after surgery(P all >0.05).There was no statistically significant differences in mean arterial pressure,heart rate and digital pulse oxygen saturation at admission,skin incision,internal fixation,extubation and departure between the three groups(P all >0.05).The incidence of post-operative nausea and vomiting in group B and C was less than that in group A(P<0.05),and there was no statistically significant difference between group B and C(P >0.05).Conclusion Total i
作者
田倩
麦思聪
孟尽海
TIAN Qian;MAI Sicong;MENG Jinhai(Ningxia Medical University,Yinchuan 750004;Department of Anesthesiology,the General Hospital of Ningxia Medical University,Yinchuan 750004)
出处
《宁夏医科大学学报》
2018年第11期1279-1283,共5页
Journal of Ningxia Medical University
关键词
电针
穴位
麻醉药
腰椎椎间融合术
恶心呕吐
electroacupuncture
acupoint
anesthetic
posterior lumbar interbody fusion
nausea and vomiting
