The Study Of Perioperative Electroacupuncture At Different Time Points On Postoperative Nausea And Vomiting In Patients Undergoing Gynecological Laparoscopic Surgery

Objective:To observe and compare the effects of electroacupuncture intervention at different time points in perioperative period on the incidence of postoperative nausea and vomiting(PONV)and the recovery of gastrointestinal function of gynecological patients undergoing laparoscopic gynecological surgery under general anesthesia,and to explore the best method of electroacupuncture application in perioperative prevention and treatment of PONV,so as to provide new treatment ideas and theoretical basis for the clinical prevention and treatment of PONV in perioperative period.Methods:A total of 100 gynecological patients who planned to undergo selective laparoscopic surgery were randomly divided into preoperative electroacupuncture group(EA1 group),postoperative electroacupuncture group(EA2 group),preoperative+postoperative electroacupuncture group(EA3 group),and conventional treatment group(C group).There were 25 patients in each group.EA1 group received electroacupuncture 30 minutes before surgery.EA2 group was treated with electroacupuncture after removal of tracheal catheter.EA3 group received the same treatment as EA1 group and EA2 group.The conventional treatment group did not receive electroacupuncture intervention.The incidence of postoperative nausea and vomiting,visual analogue scale(VAS)of pain and the time of first postoperative ventilation were compared among 4 groups.The changes of serum motilin(MTL)and gastrin(GAS)were compared between the two groups by extracting venous blood 30min before and 24h after surgery.All data were statistically analyzed using SPSS21.0.Results:A total of 101 patients were collected according to the inclusion and exclusion criteria set in this study.They were randomly divided into 4 groups.There were no significant differences in age,BMI and operative duration among all groups.The incidence of PONV in EA3 group within 72 hours was significantly lower than that in C group(P<0.05).VAS scores at each time point within 72h after surgery were not statistically significant in the 4 groups.The first postoperative exhaust time in EA3 group was significantly lower than that in C group,EA1 group and EA2 group,and the difference was statistically significant(P<0.05).The contents of gastrin and motilin in group C after operation were significantly lower than those before operation(P<0.05).There was no significant difference in the contents of gastrin and motilin in the other 3 groups before and after operation.Postoperative motilin content in EA3 group was significantly higher than that in C group,and the difference was statistically significant(P<0.05).Conclusion:Electroacupuncture can reduce the occurrence of PONV after gynecological laparoscopic surgery,and accelerate the first postoperative exhaust,and promote the recovery of gastrointestinal function.The mechanism may be related to the increase of gastrointestinal hormone concentration after operation.Preoperative and postoperative electroacupuncture has no significant difference in the prevention and treatment of PONV,but both preoperative and postoperative electroacupuncture treatment can enhance the effect,better than single time point electroacupuncture treatment.