The Influence Of Electro-Acupuncture At Different Time Combined With Intravenous Anesthesia On Postoperative Intestinal Function In Patients Undergoing Radical Resection Of Colorectal Cancer

Objective To investigates whether there exists an influence on intestinal function,lactic acid and electrol yte via electro-acupuncture(EA)at different time in the patients with colorectal cancer surgery.Methods Eighty patients with colorectal cancer about to t ook an elective surgery,aged from 18 to 59,graded ASA Ⅰ ~Ⅲ,were randomly divided into 4 groups,with 20 in each group :Group A(total intravenous anesthesia),Group B(total intravenous anesthesia combined with EA stimulation 24 hours before surgery),Group C(total intravenous anesthesia combined with EA sti mulation 24 hours and 30 minuite before surgery),Group D(total intravenous anesthesia,combined with EA stimulation 24 hours and 30 minuite before surgery and 24 hours after surgery).Groups B,C,and D received EA pretreatment on acupoints Zhongwan(CV 12)and right Tianshu(ST 25),Zusanli(ST 36),Neiguan(PC 6),Shangjuxu(ST 37),xiajuxu(ST 39).In addition,because of surgical incision,group D received EA posttreatment on right acupoints Neiguan(PC 6),Zusanli(ST 36),Shangjuxu(ST 37)and xiajux u(ST 39)24 hours postoperatively.All EA treatments lasted 0.5 hours.Postoperative ventilation time,defecation time,intake time(food and drink),extubation abdominal drainage tube removal time,abdominal drainage volume and postoperative nausea and v omiting were anal yzed.And we collected venous blood for white blood cell and neutrophil count at three time points—prior to surgery(T1),24 hours after surgery(T2),the fifth day after surgery(T3),and arterial blood to detect lact ate level at three ti me points—prior to surgery(Ta),after tumor resection and abdominal cavity flushing(Tb),24 hours after surgery(Tc).Venous blood to detect the ion concentration of potassium,sodium,and chloride at four time points—prior to surgery(TⅠ),Immediately after surgery(TⅡ),24 hours after surgery(TⅢ)and five days after surgery(TⅣ).Results On the intestinal function postoperatively,we found that for the first time of ventilation in four groups,there was no difference when group A compared with group B and C,and group B compared with group C,respectively(P>0.05),the ventilation time was shorter in the group D than in group A,B and C(P <0.05).The time of drinking water and abdominal drainage tube removal in group D was earlier than that in group A(P <0.05),and there was no difference when those in group A compared with group B and C,and group B compared with group C and D,and group C compared with group D respectively(P>0.05).The time of defecation,food intake and total amount of abdominal drai nage in the four groups were no statistically significant(P >0.05).The postoperative complications such as nau sea,vomiting and fever were no statistically significant among four groups(P >0.05).On the inflammation indicator,the count of leukocyte and neutrophil among groups were no difference at T1(P >0.05).Compared with group A,the count of leukocyte and neutrophil in group B and D decreased at T2 and T3(P <0.05),but there was no difference when those in group A compared with group B,and group B compared with group C and D,and group C compared with group D respectivel y(P >0.05).Within groups,the white blood cells and neutrophil count increased significantl y at T2 than T1(P <0.01),the count of neutrophils in group B and the count of leukocytes,neutrophils in group D increased significantly at T2 than T1(P <0.01).Compared with T2,the count of leukocytes and neutroph ils decreased significantl y at T3(P <0.01).On the lactate indicator among groups,there were no statistical significances a t Ta Tb Tc(P >0.05).Within groups,compared with Ta,blood lactate level in four groups increased significantl y at Tb(P < 0.01).Compared with Tb,blood lactate level of group C decreased at Tc(P < 0.05),and A,B,D group of lactic acid value decreased significantly at Tc(P <0.01).On the ion concentration of potassium,sodium,and chloride from plasma among groups and within groups,there were no statistical significances(P >0.05).Conclusion Electro-acupuncture combined with intravenous anesthesia can promote intestinal function recovery in patients with colorectal cancer and reduce inflammatory cell counts after operation.Preoperative electro-acupuncture preconditioning combined with postoperative electro-acupuncture stimulation is more effective.There was no obvious effect on blood lactic acid and electrolyte.