摘要
目的 探讨围术期经皮穴位电刺激(percutaneous acupoint electrical stimulation,TEAS)对全髋关节置换术后老年患者自控静脉镇痛效果的影响。方法 选择2015年6~12月择期行全髋关节置换术的老年患者80例。采用随机数字表法分为TEAS组(T组)和对照组(C组),每组40例。T组麻醉诱导前30min于双侧合谷穴和内关穴行TEAS至手术结束后30 min,频率2~100 Hz,采用疏密波,根据患者可耐受程度刺激电流强度维持在6~10 mA;C组在相同穴位上贴电极片并连接治疗仪但不做电刺激。2组患者术后均采用芬太尼静脉自控镇痛。观察2组患者术后6、12、24、48 h静息和活动时的疼痛视觉模拟评分(VAS评分),术后48 h镇痛方案满意度评分,镇痛泵芬太尼用量和恶心、呕吐、瘙痒、呼吸抑制等不良反应的发生情况。结果 与C组比较,T组术后12 h静息时VSA评分明显降低,术后6、12 h活动时VAS评分明显降低,术后6、24、48 h芬太尼累计用量明显减少,术后恶心、呕吐等不良反应的发生率明显降低(P<0.05),术后48 h满意度评分差异无统计学意义(P>0.05)。结论 围术期TEAS可减轻全髋关节置换术后老年患者的疼痛程度,减少阿片类药物用量,降低术后不良反应发生率。
Objective To investigate the effects of perioperative transcutaneous electrical acupoint stimulation(TEAS)on intravenous patient-controlled analgesia(PCA)in elderly patients after total hip arthroplasty.Methods Eighty elderly patients,who underwent total hip replacement in our hospital from June 2015 to December 2015,were randomly divided into TEAS group(n=40)and control group(n=40).The patients in TEAS group were stimulated by TEAS at Hegu point and Neiguan point of both sides for 30 min before anesthesia induction,with frequency of 2~100Hz,disperse dense waves and current intensity of 6~10mA.The electrode plates placed at the same acupoints of patients in control group were connected with therapeutic instrument.The patients in both groups were treated by sufentanil for postoperative PCA.The VAS scores at rest and during exercise at 6h,12h,24h,and 48h after surgery,satisfaction scores at 48h after surgery and the incidences of adverse effects(nausea,vomiting,pruritus,and respiratory depression)of the patients in both groups were observed and compared.Results As compared with those in control group,the VAS scores at rest at 12h after surgery,the VAS scores during exercise at 6h and 12h after surgery,the cumulative damage of fentanil at 6h,12h and 48h after surgery and the incidences of adverse effects in TEAS group were significantly decreased(P<0.05).And there were no significant differences in the satisfaction degree scores at 48h after surgery between the two groups(P<0.05).Conclusion The perioperative TEAS can reduce the pain of the elderly patients after total hip replacement,the doses of opiate drug and the incidence of adverse effect after surgery.
作者
彭毅
邱延伟
陈和伟
白云
刘佳
刘志奇
张玉强
王福刚
郑如庚
PENG Yi;QIU Yanwei;CHEN Hewei(Department of Anesthesiology,Shijiazhuang First Hospital,Hebei,Shijiazhuang 050011,China)
出处
《河北医药》
CAS
2019年第19期2972-2975,共4页
Hebei Medical Journal
关键词
经皮穴位电刺激
术后镇痛
全髋关节置换术
老年患者
transcutaneous electrical acupoint stimulation
postoperative analgesia
total hip replacement
senile patient
