| Objective:The purpose of this study was to evaluate the effects of different acupoints compatibility with transcutaneous electrical acupoint stimulation(TEAS)for postoperative pain and sleep quality in patients undergoing laparoscopic cholecystectomy.Methods There were 140 patients scheduled for elective laparoscopic cholecystectomy under general anesthesia,aged 18～65 years,body mass index 18.5～24.0 kg/m2,of American Society of Anesthesi dogists physi cal status gradeⅠ～Ⅲ,any gender.Usi ng the random number table method,the patients were divided into four groups(n=35):conventional general anesthesia group(group G),hegu acupoint(LI 4)+neiguan acupoint(PC 6)(group TG2),hegu acupoint(LI 4)+neiguan acupoint(PC 6)+zusanli acupoint(ST 36)(group TG3)and hegu acupoint(LI 4)+neiguan acupoint(PC 6)+zusanli acupoint(ST 36)+sanyinjiao acupoint(SP 6)(group TG4).Only conventional general anesthesia was performed in group G.Routi ne fasting and dri nki ng were prohi bited before operati on.Anesthesi a induction:intravenous midazolam 0.05～0.15 mg·kg-1,etomidate 0.2 mg·kg-1,sufentanil 0.3～0.5 μg·kg-1 was given for general anesthesia induction,intravenous injection of benzosulfonate with atacurium 0.2 mg·kg-1 was given,endotracheal intubation was performed,anaesthetic machine was connected,ventilation frequency was 12～14 bpm,tidal volume was 8～10 mL·kg-1,aspiration ratio was 1:2.Maintain end-tidal carbon dioxide of 35～45 mmHg(1 mmHg=0.133 kPa).Anaesthesia maintenance:inhalation of 1%sevoflurane,intravenous pumping of propofol 3～10 mg· kg-1·h-1 and remifentanil 0.05～0.20μg·kg-1,min-1,remifentanil and remifentanil were adjusted according to BIS value,and the BIS value was kept stable at 40～60.When postoperative VAS score≥4,the 5 mg of dizocine was injected intravenously for relief analgesia.TEAS combined with general anesthesia were performed in Groups TG2,TG3 and TG4.And the TEAS was performed with the SDZ-Ⅱelectronic acupuncture instrument of Huatuo brand.The set parameters induded the stimulation frequency of 2/100 Hz,the density wave and the maximum current that the patient can withstand.At 30 minutes before anesthesia induction,patients in groups TG2,TG3 and TG4 group were intervened with TEAS until the end of operation(the end of seam skin).Other steps were the same as group G.The dosages of propofol and remifentanil were recorded.VAS score and remedy analgesia rate were recorded at 1,6,12 and 24 h after surgery.Sleep quality score was recorded 24 h before and after surgery.The incidence of adverse events including intraoperative hypertension,hypotension,bradycardia and tachycardia was recorded.Results Compared with group G,the dosages of propofol and remifentanil dosage postoperative remedy analgesia rate,VAS score at 6 h after operation and sleep quality score at 24 h after operation were reduced in groups TG2,TG3 and TG4(P<0.05).The 12 h postoperative VAS score of the group TG4 reduced compared with group G(P<0.05);Corrpared with the groups TG2 and TG3,the sleep quality score at 24 h after operation decreased in group TG4(P<0.05);The incidence rates of hypertension,hypotension,tachycardia,bradycardia and tachycardia during the operation had no significant difference among the four groups(P>0.05).Conclusion:In the acupoints oompatibility of TEAS,the three modes of acupoints compatibility can be safely and effectively Used in patients with laparoscopic cholecystectomy,and the mode of hegu acupoint(LI 4)+neiguan acupoint(PC 6)+zusanli acupoint(ST 36)+sanyinjiao acupoint(SP 6)compatibility can decrease the dosages of intraoperative propofol,remifentanil dosage and postoperative remedy analgesia rate And the imprcvements of postoperative analgesia effect and sleep quality were superior to other acupoints compatibility. |
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