摘要
目的:观察经皮穴位电刺激(TEAS)内关穴在保留自主呼吸全身麻醉胸腔镜肺叶切除术中的应用效果。方法:将66例行胸腔镜肺叶切除术的原发性肺癌患者随机分为观察组(33例,中止1例)和对照组(33例)。观察组于麻醉诱导前30min至手术结束采用TEAS内关穴治疗。记录两组患者手术时间、呼气末二氧化碳分压(PETCO_(2))最高值、血氧饱和度(SpO_(2))最低值;统计丙泊酚、舒芬太尼、瑞芬太尼及右美托咪啶的用量。于麻醉诱导前(T0)、手术开始时(T1)、胸腔探查时(T2)、肺叶切除时(T3)、肺叶切除后30min(T4)、肺叶切除后60min(T5),检测患者平均动脉压(MAP)、心率(HR)、呼吸频率(RR)及血清皮质醇(Cor)、去甲肾上腺素(NE)含量。比较两组患者麻醉后监护室(PACU)停留、下床活动、肛门排气、胸腔引流时间及恶心呕吐发生率。结果:观察组患者PETCO_(2)最高值、丙泊酚及瑞芬太尼用量低于对照组(P<0.05,P<0.01),SpO_(2)最低值高于对照组(P<0.01)。T1~T5时,观察组患者MAP、HR及血清Cor、NE含量低于对照组(P<0.05)。观察组患者下床活动时间、肛门排气时间、胸腔引流时间及恶心呕吐发生率低于对照组(P<0.001,P<0.01)。结论:TEAS内关穴用于保留自主呼吸全身麻醉胸腔镜手术,可减轻机体应激反应,减少阿片类药物用量,促进术后康复。
Objective To evaluate the effect of transcutaneous acupoint electrical stimulation(TEAS)at Neiguan(PC 6)on general anesthesia under preserving spontaneous breathing in thoracoscopic lobectomy.Methods A total of 66 patients of primary lung cancer undergoing thoracoscopic lobectomy were divided to an observation group(33 cases,1 case discontinued)and a control group(33 cases).In the observation group,TEAS at Neiguan(PC 6)was used 30 min before anesthesia induction till the end of surgery.The surgery time,maximum value of partial pressure of end-tidal carbon dioxide(PETCO_(2))and minimum value of oxygen saturation(SpO_(2))of the two groups were recorded.The dosage of propofol,sufentanil,remifentanil and dexmedetomidine were analyzed.Separately,before induction(T0),at the start of surgery(T1),thoracic exploration(T2)and lobectomy(T3),as well as 30 min(T4)and 60 min(T5)after lobectomy,the mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR),serum cortisol(Cor)and norepinephrine(NE)were measured.The time of post anesthesia care unit(PACU)stay,ambulation,flatus,chest drainage and the incidence of nausea and vomiting were compared between the two groups.Results The maximum value of PETCO_(2),the dosage of propofol and remifentanil in the observation group were lower than those in the control group(P<0.05,P<0.01),the minimum value of SpO_(2) in the observation group was higher than that of the control group(P<0.01).At T1-T5,the MAP,HR,serum Cor and NE levels in the observation group were all lower than those in the control group(P<0.05).The ambulation time,the time for the flatus,chest drainage time,and the incidence of nausea and vomiting in the observation group were all lower than those in the control group(P<0.001,P<0.01).Conclusion For the general anesthesia under preserving spontaneous breathing in thoracoscopic surgery,TEAS at Neiguan(PC 6)relieves stress response,reduces opioids dosage and promotes postoperative recovery.
作者
丁艺
粟胜勇
林雅丽
韦懿桐
石俊丹
高斯莉
卓金义
蔡元春
DING Yi;SU Sheng-yong;LIN Ya-li;WEI Yi-tong;SHI Jun-dan;GAO Si-li;ZHUO Jin-yi;CAI Yuan-chun(Department of Anesthesiology,First Affiliated Hospital of Guangxi University of CM,Nanning 530023,China)
出处
《中国针灸》
CAS
CSCD
北大核心
2023年第3期282-286,共5页
Chinese Acupuncture & Moxibustion
基金
广西壮族自治区中医药局自筹经费科研项目:GZZC2019050、GZZC2019048
广西中医药大学高层次人才培育创新团队资助项目:2022B007。
关键词
原发性肺癌
胸腔镜肺叶切除术
经皮穴位电刺激
穴
内关
保留自主呼吸
随机对照试验
primary lung cancer
thoracoscopic lobectomy
transcutaneous acupoint electrical stimulation
Point PC 6(Neiguan)
preserving spontaneous breathing
randomized controlled trial(RCT)
