| Objective:This study aimed to evaluate the effect of transcutaneous electrical acupoint stimulation（TEAS）on perioperative hemodynamic and oxidative stress（OS）responses in patients with craniotomy aneurysm clipping,and to provide a theoretical basis for its application in craniotomy aneurysm clipping surgery.Methods:According to the inclusion and exclusion criteria,42 patients who underwent elective craniotomy aneurysm clipping at the First Affiliated Hospital of Gannan Medical University from October 2021 to September 2022 were enrolled and randomly divided into two groups according to computer randomization:control group（group C）and transcutaneous electrical acupoint stimulation group（group T）.Group T was the TEAS group,Group C was the placebo-type TEAS group,and the T group used the"HANS"transcutaneous acupoint electrical stimulator to perform electrical stimulation on the patient’s“Hegu”（LI4）,“Neiguan”（PC6）and“Zusanli”（ST36）,adjusted the frequency to 2/100 Hz,the intensity was<10 m A（the maximum intensity that the patient can tolerate）,and TEAS was administered 30 min before anesthesia induction until the end of the operation."Placebo-type HANS"transcutaneous acupoint electrical stimulator was used in group C,and the acupoint selection principle was the same as that in group T.The mean arterial pressure（MAP）and heart rate（HR）were recorded5 min before the TEAS intervention（T0）,5 min before head holder pinning（T1）,immediately after pinning（T2）,5 min before craniotomy（T3）,immediately after craniotomy（T4）,at craniotomy（T5）,and at the end of surgery（T6）,and recorded intraoperative doses of remifentanil and propofol.Peripheral blood samples of patients were collected at T0,T2,T6,and 24 h after surgery（T7）.Enzyme linked immunosorbent assay（Elisa）detected the levels ofβ-endorphins in serum at T0,T2 and T6,as well as the levels of central nervous system-specific protein（S100β）and neuron specific enolase（NSE）in serum at T0,T2 and T7.The levels of superoxide dismutase（SOD）and malondialdehyde（MDA）in serum T0,T2 and T7 were detected by hydroxylamine method and thiobarbituric acid（TBA）,respectively.Results:General and intraoperative conditions:There were no significant differences in age,sex,BMI,ASA grading,intraoperative infusion volume,blood loss,fluid rehydration volume,urine volume and operation time between the two groups（P>0.05）.There were no significant differences in MAP and HR between the two groups at T0 time（P>0.05）.Intra-map comparison:Compared with T0,MAP in group C and T was decreased at T1,T3 and T6（P<0.05）;Intra-group comparison in HR:Compared with T0,HR in group C was decreased at T1,T3,T4,T5 and T6（P<0.05）,and HR in group T was decreased at T1,T2,T3,T4,T5 and T6（P<0.05）.Comparison of MAP and HR between groups:at time T2,T4and T5,MAP and HR in group T were lower than those in group C（P<0.05）.Remifentanil dosage:The dosage of remifentanil in group T was lower than that in group C（P<0.05）.Propofol dosage:There was no statistical difference in the dosage of propofol between T group and C group（P>0.05）.Serological indexes:There were no significant differences inβ-endorphin,SOD,MDA,NSE and S100βbetween the two groups at T0（P>0.05）.（1）Comparison ofβ-endorphin results:In group comparison:compared with T0,there were no significant differences at each time point（P>0.05）;Comparison between groups:at T2 and T6,there was no significant difference inβ-endorphin level between groups T and C（P>0.05）.（2）Results of SOD and MDA:Compared with T0,SOD level in group C at T2 and T7 was decreased（P<0.05）.Compared with T0,MDA level in T group at T2 and T7was decreased（P<0.05）.The SOD level of group T was higher than that of group C at T2 and T7（P<0.05）.The MDA level of group T was lower than that of group C at T2and T7（P<0.05）.（3）Results of NSE and S100β:Intragroup comparison:Compared with T0,there were no significant differences in NSE and S100βbetween C and T groups at T2 and T7（P>0.05）.Comparison between groups:at T2 and T7,the levels of NSE and S100βin group T were lower than those in group C（P<0.05）.Conclusion:（1）TEAS can reduce the intraoperative dose of remifentanil and reduce hemodynamic fluctuations in patients undergoing cranial aneurysm clipping.（2）TEAS can reduce the occurrence of oxidative stress and central nervous system injury during craniotomy,and play a protective role in brain. |
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