Observation On The Effect Of Electroacupuncture Stimulation On Analgesia And Sedation In Patients With Mechanical Ventilation

Objective:Observation for the ICU severe patients receiving mechanical ventilation who receive pharmacological therapy for analgesia and sedation plus electroacupuncture stimulation method (experimental group, EG), while the other group only receive pharmacological therapy for analgesia and sedation (control group, CG). Whether the incidence of pain and agitation could be reduced, the depth of sedation and analgesia could be increased, the dosages of analgesic and sedative drugs could be reduced in EG.Methods:A randomized, controlled, prospective study method was used. Sixty patients (male 33, female 27) who meet the inclusion criteria were randomly and equally divided into experimental group (EG) and control group (CG) by random number method in the intensive care unit. Eight patients (2 cases in EG,6 cases in CG) were dropped out during the treatment. At last, fifty-two cases (Male 28, Female 24) were enrolled and evaluated,28 cases in EG (Male 16, Female 12),24 cases in CG (Male 12, Female 12). Both EG and CG were given anti infection, symptomatic fluid resuscitation, and mechanical ventilation as the progression of disease. The CG received pharmacological therapy for analgesia and sedation with conventional western medicine, including fentanyl citrate(0.7-10ug/kg. h, continuous intravenous infusion for maintenance analgesia) and dexmedetomi dine (lug/kg loading dose of intravenous infusion of 10min, then 0.2-0.7ug/kg. h, continuous intravenous infusion for maintenance sedation). At the beginning of the sustained use of analgesic-sedative agents and 24 hours after the therapy, the EG was treated with electroacupuncture:2HZ/100HZ alternating frequency (each 3S) electroacupuncture in Hegu, Zusanli acupoint, lasting 30 minutes, until 2 electroacupuncture treatments were all over. The dose adjustments of fentanyl citrate and dexmedetomidine were needed according to the patients’depth of sedation. For the severe restlessness patients, it’s necessary to combine with propofol or midazolam to keep under sedation, and these patients should be excluded in the experiment. The experimental data were analyzed using SPSS V.22 for statistical analysis. T test should be used for measurement data of two independent samples which conform to the normal distribution, or else rank-sum test should be selected, chi-square test should be used for categories of data. P<0.05 was referred to as a statistically significant difference. The scores of CPOT and SAS of both of EG and CG were recorded after the treatment was beginning 1 hours (1H) and 25 hours (25H). Calculating the total doseages of analgesic and sedative drugs of all patients of 24H and 48H. Recording the number of clinical adverse events such as:heart rate drops, in blood pressure drops, agitation and delirium during the treatment.Results:All the patients were needed receive mechanical ventilation and analgesic-sedative treatment due to the disease progresses (before they were received analgesic-sedative treatment, the score of CPOT≥3, and the score of SAS≥5). The difference in the age, weight, the score of Apache Ⅱ, the score of CPOT, the score of SAS of the patients between two groups were not statistically significant(P>0.05). The conclusion shows that the doseages of analgesic and sedative drugs in EG were lesser than CG (P<0.05). The patients were received analgesic-sedative treatment after 1 hour (1H) and 25 hours (25h), their scores of CPOT and SAS had no difference between the EG and the CG (P>0.05). The frequency of adverse clinical events, such as heart rate drops, blood pressure drops, agitation and delirium, also had no significant difference(P>0.05).Conulusion:The clinical observation of electroacupuncture stimulation in Hegu and Zusanli acupoint for patients receiving mechanical ventilation in ICU confirmed the effects by combining the analgesia-sedation agent with electroacupuncture stimulation, which can strengthen the depth of sedation and analgesia, reduce the dosages of analgesic and sedative drugs and contribute to the ICU sedation and analgesia.