Effect Of High-frequency Electroacupuncture Stimulation Of The Stellate Ganglion On The Stress Response In Patients Undergoing Upper Limb Fracture Surgery

Objective To investigate the effects of high frequency electroacupuncture stimulation on the stellate ganglion of the affected limb before surgery on the physical stress response and inflammation response during and after surgery in patients with upper limb fracture and general anesthesia,in order to verify the therapeutic effect of high frequency electroacupuncture stimulation on the stress response of the body.Methods 1.From December 2021 to January 2023,70 patients who were scheduled to receive general anesthesia surgery due to upper limb fracture and met the criteria of Inclusion and exclusion were selected and divided into control group and experimental group,35 patients in each group according to random number table method.The experimental group received 20min stimulation of the affected limb stele ganglion by high frequency electroacupuncture before surgery plus general anesthesia,while the control group received blank control plus general anesthesia 2.General data of patients in the two groups were collected,including gender,age,BMI,operation time,intraoperative blood loss,etc.3.Observe,record and collect the hemodynamic indexes(HR and MAP)at five time points of entering the operating room(T1),immediately after endotracheal intubation(T2),at the beginning of surgery(T3),at the end of surgery(T4)and at endotracheal extubation(T5).Stress response blood indexes(epinephrine,norepinephrine,cortisol)and inflammatory response indexes(TNF-α,IL-6).4.Intraoperative opioid dosage(Sufentanil and remifentanil),anesthesia depth(BIS value)at time points T2,T3 and T4 were recorded,and pain scores(VAS score)were followed up 24 hours after surgery.Results 1.There were no significant differences in general information(gender,age,BMI)and intraoperative conditions(operation time,intraoperative blood loss)between the two groups(P>0.05).2.There was no significant difference in MAP changes between the two groups at time points T1,T2,T3,T4 and T5(P>0.05);At the time points T2,T3 and T4,HR of the experimental group was lower than that of the control group,with statistical difference(P<0.05),but there was no significant change in HR at T1 and T5(P>0.05).3.Compared with the experimental group and the control group,there was no significant difference in stress response indexes(epinephrine and norepinephrine)at T1 and T5 time points(P>0.05);Both epinephrine and norepinephrine in the experimental group were lower than those in the control group at time points T3 and T4(P<0.05);The levels of cortisol in T4 and T5 were statistically different between the two groups(P<0.05);There were no significant differences in inflammatory response indexes(TNF-α,IL-6)at T1,T2 and T3(P>0.05);However,in T4 and T5,the inflammatory response indexes in the control group were significantly increased,and the difference was statistically significant(P<0.05).4.Intraoperative opioid consumption decreased in the experimental group(P<0.05);At T2,T3 and T4,there was no significant difference in BIS values between the two groups(P>0.05);There was no significant difference in VAS scores 24 hours after surgery(P>0.05).Conclusion 1.Preoperative application of high-frequency electroacupuncture stimulation of the stellate ganglion reduces the operative heart rate,inhibits the stress response during surgical anesthesia,and reduces the intraoperative opioid dosage and the release of inflammatory factors in patients.2.High frequency electroacupuncture could not inhibit the stress response of tracheal intubation and tracheal extubation in general anesthesia.