摘要
目的:观察意识指数(IOC)监测下经皮穴位电刺激(TEAS)在无痛胃镜检查时对麻醉药用量、体动反应、血压、心率、血氧饱和度和恶心呕吐等方面的影响。方法:选取2021年6月—2022年3月在我院门诊行无痛胃镜检查的患者300例,随机分成TEAS组、舒芬太尼组及对照组,每组100例。所有患者入室后均进行意识指数、血压、心率及血氧饱和度监测,维持IOC1值为40~60,IOC2值为30~50时行胃镜检查。TEAS组:入室前10 min TEAS右侧合谷、内关、足三里、梁丘穴直至检查结束,入室后静脉注射生理盐水0.5 mL,1%丙泊酚0.15~0.25 mL/kg;舒芬太尼组:静脉注射舒芬太尼0.05μg/kg,1%丙泊酚0.15~0.25 mL/kg;对照组入室后静脉注射生理盐水0.5 mL,1%丙泊酚0.15~0.25 mL/kg。记录各组患者丙泊酚用量、术前(T1)、给药后1 min(T2)、进镜时(T3)及术毕(T4)的平均动脉压、心率、血氧饱和度,并观察低血压、高血压、低氧血症、体动反应、注射痛、恶心呕吐发生情况及苏醒时间。结果:TEAS组在T3时平均动脉压、心率、丙泊酚用量及注射痛、术中低血压发生率明显低于对照组(P<0.05),与舒芬太尼组无明显差别(P>0.05);TEAS组术中低氧血症发生率低于舒芬太尼组和对照组(P<0.05);舒芬太尼组术后恶心呕吐发生率明显高于TEAS组和对照组(P<0.05);三组术中体动反应无明显差别(P>0.05)。结论:TEAS能减少胃镜检查中丙泊酚用量,降低不良反应发生率。
Objective To observe the effects of transcutaneous electrical acupoint stimulation(TEAS)on anesthetic dosage,blood pressure,heart rate,oxygenation and adverse reactions during painless gastroscopy under the monitoring of Consciousness Index.Methods 300 patients undergoing painless gastroscopy were randomly divided into TEAS group,sufentanil group and control group with 100 cases in each group.All patients were monitored for consciousness index,blood pressure,heart rate and oxygenation.Gastroscopy was performed when IOC1 was maintained at 40-60 and IOC2 at 30-50.TEAS group:10 minutes before entering the operating room TEAS with right Hegu,Neiguan,Zusanli and Liangqiu point until the end of the examination.Normal saline 0.5 mL and 1%propofol 0.15-0.25 mL/kg were injected intravenously after entering the operating room.Sufentanil group:Sufentanil 0.05μg/kg,1%propofol 0.15-0.25 mL/kg were given intravenously.Control group:Normal saline 0.5 mL and 1%propofol 0.15-0.25 mL/kg were injected intravenously after entering the operating room.Mean arterial pressure(MAP),heart rate(HR)and Oxygenation were recorded before propofol administration(T1),1 min after propofol administration(T2),at endoscopy(T3)and at the end of gastroscopy(T4).The incidence of hypotension,hypertension,hypoxemia,body reaction,injection pain,nausea and vomiting and the time of recovery were observed.Results The mean arterial pressure,heart rate at T3,propofol dosage,injection pain and the incidence of intraoperative hypotension in the TEAS group were significantly lower than those in the control group(P<0.05),there was no difference in the Sufentanil group(P>0.05).The incidence of hypoxemia in TEAS group was lower than that in Sufentanil group and control group(P<0.05).The incidence of postoperative nausea and vomiting in sufentanil group was significantly higher than that in TEAS group and control group(P<0.05).There was no difference in the kinesthetic response among the three groups(P>0.05).Conclusion TEAS can reduce the dosage of propofol in gastr
作者
高艺凡
于艳宏
王悦
李宏
GAO Yi-fan;YU Yan-hong;WANG Yue(Department of Anaesthesia,Center for People's Armed Police Medicine,Tianjin(300000),China)
出处
《中国中西医结合外科杂志》
CAS
2023年第4期497-500,共4页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
基金
天津麻醉科研发展计划项目(TJMZ2021-005)。
关键词
经皮穴位电刺激
意识指数
无痛胃镜
Transcutaneous acupoint electrical stimulation
consciousness index
painless gastroscopy
