| Objective To investigate the effects on postoperative cognitive function,dosage of intraoperative anesthetics and postoperative nausea and vomiting via electro-acupuncture stimulation in patients with lumbar surgery under general anesthesia.Methods Seventy-eight patients aged from 18 to 59 years with ASA grade I-II undergoing selective posterior lumbar interbody fusion were selected from our hospital.They were randomly divided into 3 groups,26 cases in each group:Group A(total intravenous anesthesia);group B(total intravenous anesthesia combined with EA stimulation at Baihui,Si Shencong and bilateral Neiguan);group C(total intravenous anesthesia combined with EA stimulation at Baihui,Si Shencong,and bilateral Hegu、Neiguan、Zusanli).In group B and group C,EA stimulation was administered at one day before the operative and 30 minutes before induction of anesthesia.EA stimulation lasted for 30 minutes on the day before operation,and on the day of the operation,acupuncture lasted from 30 minutes before the induction of anesthesia to the end of suture.The scores of Mini Mental State Examination(MMSE)and time of Trial Making Test(TMT)at one day before the surgery、one day and third day after the surgery were recorded.We also analysis the intraoperative dosage of midazolam,sufentanil and cisatracurium besylate,propofol,remifentanil,the score of Visual Analogue Scale(VAS)on the first day after operative and the number of cases of postoperative nausea and vomiting(PONV).Results One case was eliminated in each group.Comparison of MMSE scores in three groups: On the first day and third day after operation,the MMSE scores were higher in group B and group C compare with that in group A(P<0.05),while no significant difference exist in both group B and group C(P > 0.05).The MMSE scores of the three groups on the first day and third day after operation were lower than those on the first day before operation(P<0.05).Compared with the first day after operation,there was no significant difference on the third day after operation(P > 0.05).2.Comparison of the time of TMT in three groups: there was no significant difference in the time of TMT between the three groups on the first day before operation and the third day after operation(P > 0.05).On the first day after operation,TMT time in group B and group C was less than that in group A(P<0.05),while no significant difference exist in both group B and group C(P > 0.05).Compared with one day before operation,the time of TMT in group A was significantly prolonged on the first day after operation(P<0.05),but there was no significant difference between group B and group C(P > 0.05).Compared with one day before operation,there was no significant difference in TMT time between the three groups on the third day after operation(P > 0.05).Compared with the first day after operation,the time of TMT in group A decreased on the third day after operation(P<0.05),while no significant difference exist in both group B and group C(P > 0.05).3.Comparison of intraoperative anesthetic dosage in three groups: Remifentanil dosage was higher in group A compared with group B and group C(P<0.05),and no difference was found between group B and group C(P > 0.05);Meanwhile,there was no significant difference in intraoperative midazolam,propofol,sufentanil,cisatracuridine bensulfonate dosage among the three groups(P > 0.05).4.Comparison of postoperative nausea and vomiting and VAS score in three groups: The number of postoperative nausea and vomiting in group B and group C was less than that in group A(P<0.05),and there was no significant difference between group B and group C(P > 0.05).There was no significant difference in VAS score among the three groups on the first day after operation(P > 0.05).Conclusion Total intravenous anesthesia combined with electro-acupuncture stimulation at acupoints can improve postoperative cognitive function,reduce the amount of intraoperative dosage of remifentanil and postoperative nausea and vomiting in patients undergoing lumbar surgery. |
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