| Objective: To investigate the curative effect of percutaneous acupoint electrical stimulation(Tetr As)on prevention and treatment of nausea and vomiting(PONV)after hip and knee replacement,and to provide a new idea and method for the prevention and treatment of postoperative nausea and vomiting by combining traditional Chinese and Western medicine.Methods: A total of 90 patients undergoing coxy-knee replacement under combined lumbic-epidural anesthesia in Affiliated Hospital of Shandong University of Traditional Chinese Medicine from April 2022 to December 2022 were selected and divided into percutaneous acupoint electrical stimulation group(T group),percutaneous non-acupoint electrical stimulation group(N group)and blank control group(C group)according to random number table method,with 30 patients in each group.Patients in T group were subjected to acupoint electrical stimulation 30 minutes before anesthesia.Xinshu,Feishu,Zhongwan and Guanyuan were selected as acupoints.The waveform of electrical stimulation instrument was selected as dense wave.In group N,non-acupoint electrical stimulation was performed 30 minutes before anesthesia.Electrodes were placed near Xinshu,Feishu,Zhongwan and Guanyuan to ensure that no acupoints existed at the placement sites.Other operations were the same as those in group T.Group C is not given any operation.Patients’ age,gender,body mass index(BMI),operation time,anesthesia time,and intraoperative volume(input-out)were recorded,and patients were followed up at T1(0-6h after surgery),T2(6-12 h after surgery),T3(12-24 h after surgery),and T4(24-48 h after surgery).The occurrence of postoperative nausea and vomiting,visual analog score(VAS)of pain,visual analog score(NVAS)of nausea and vomiting degree,whether antiemetic drugs were used or not,and whether opioids were used.The postoperative hospitalization days and hospitalization satisfaction score of patients were recorded at discharge.Results: There were no significant differences in age,BMI,operation time,anesthesia time,intraoperative volume and VAS scores in T1,T2,T3 and T4 among the three groups(P > 0.05),indicating homogeneity and comparability among the three groups.The incidence of PONV in T group was 6.67%.The incidence of PONV in N group was 30.00%;The incidence of PONV in group C was33.33%,and the difference among the three groups was statistically significant(P < 0.05).Pairwise comparison showed that P < 0.05 was found in group T compared with the other two groups,while P > 0.05 was found in group N compared with group C.The visual analog score(NVAS)of nausea and vomiting in T1 and T2 time periods of the three groups were all < 0.05,with statistical significance;the visual analog score(NVAS)of nausea and vomiting in T3 and T4 time periods of the three groups were all > 0.05,with no statistical significance.After pairwise comparison,in T1 and T2 time periods,The visual analog score(NVAS)of nausea and vomiting in group T and the other two groups were all < 0.05,and the differences were statistically significant.The visual analog score(NVAS)of nausea and vomiting in group N and group C was P > 0.05,and the differences were not statistically significant.The inter-group comparison of the use of remedial antiemesis drugs within 48 h after surgery,the number of days in hospital and the satisfaction at discharge of the patients in the three groups all had P values< 0.05,the differences were statistically significant.After pairwise comparison,the P values of the three indicators in the T group were all <0.05 compared with the other two groups,the differences were statistically significant.The P values of the three indexes were all > 0.05,and the difference was not statistically significant.Conclusion: Tetr As guided by the three-coke theory can effectively reduce the incidence of PONV,relieve the degree of nausea and vomiting,reduce the use of postoperative remedial antiemetic drugs,shorten the length of hospital stay and improve patient satisfaction,and are worthy of clinical promotion. |
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