Effect Of Transcutaneous Electrical Acupoints Stimulation On Propofol-targeted Concentration And Stress Response

Objective To observe the effect of transcutaneous electrical acupointsstimulation(TEAS) on propofol-targeted concentration and stress respense as thebispectral index (BIS) was maintained at 45-55.Methods Forty ASA gradeⅠorⅡpatients, scheduled for elective epigastricsurgery, were randomly divided into two groups with 20 patients in each group: groupA, TEAS combined with propofol anesthesia (trentment group,n=20) and groupB,propofol anesthesia (control group, n=20). The patients were receivedintramuscular Phenobarbital (0.1g) and scopolamine (0.3mg) 1h beforeinduction.Before induction of anesthesia, firstly, group A transcutaneous electricalstimulated hibateral Neiguan and Zusanli acupoints for 30min and group B standingfor 30min.Then anesthesia was induced with midazolam 0.03mg·kg-1,fentanyl3μg/kg and propofol TCI (C=2μg/mL) started instantly.Tracheal intubation wasfacilitated with vecuronium 0.12 mg. kg-1. Perioperative group A was sustainingelectrical stimulated hibateral Neiguan and Zusanli acupoints. Fentanyl was givenaccording to hemodynamic changes and BIS was maintained at 50±5 by adjustment oftarget-effect propofol concentration during the operation.To stop using all anestheticsand try waking the patients up when the operation was end.The time from the end ofthe operation to palinesthesia (open the eyes in response to verbalcommand), extubation, orientation regaining and hemodynamic changes wererecorded.The BIS,HR,MAP, Propofol-targeted concentration were recorded atpreanesthesia pre-intubation, post-intubation,pre-incision,post-incision,operationexploring and the end of the operation. We also recorded the total dosage offentanyl.At the same time,blood samples were taken to measure the concentrations ofAGⅡand COS by radioimmunassay.Results①Compared with baseline values,there were significant decrease inBIS,HR and MAP in group A after electric stimulation.②PropofoI-targetedconcentration and total dosage of fentanyl in group A were significant decrease compared with that in group B (P＜0.01).③The hemodynamics in group A was morestable than that in group B (P＜0.01).④Compared with baseline values, AGⅡandCOS in group A were no significant difference during operation. In group B., AGⅡand COS during operation exploring were significantly higher than thatbaseline.⑤The time from the end of the operation to palinesthesia, extubation andorientation regaining were significant shorter in group A than that in group B.Conclusions TEAS Combined with propofol can reduce the targeteffective-site concentration of propofol and the totall dosage of analgesics, depress thestress response and maintain the hemodynamics more stable. Meanwhile, TEASCombined with propofol allows faster recovery from anesthesia.