| ObjectiveThe transcutaneous acupoint electrical stimulation, dexmedetomidine and electric acupuncture was operated on patients with laparoscopic complete hysterectomy under general anesthesia to observe:①the influence of artificial pneumoperitoneum to Oxidative Stress Reaction in Perioperative patients, ②the influence of the three interventions to Oxidative Stress Reaction in Perioperative patients.Methods80 patients, aged 29～65, with average age of 49, who had complete hysterectomy under general anesthesia were collected. The ASA classification is class I-class II. These 80 cases were randomly divided into group E with Electroacupuncture, group C with general anesthesia, group D with dexmedetomidine and group T with transcutaneous acupoint electrical stimulation.2 cases of transfer laparotomy were excluded, and finally 78 patients’data were successfully collected. The patients having severe anxiety or having severe depression before the surgery were excluded by self rating depressing scale(SDS), self rating anxiety scale(SAS). All patients were intramuscular injected atropine 0.5 mg before operative 30 min. The patients in the group E and group T were given acupoint stimulation in the acupuncture points of Sanyinjiao (SP6),Zusanli (ST36), Xuehai (SP10) at 30min before anesthesia, and the Anesthesia induction intubation after the above operation of 30min. 0.5ug·kg-1 of dexmedetomidine was given to Group D in 10mins before the anesthesia. Dexmedetomidine was continuously uniformly being pumped by 0.3ug·kg-1·h-1 during the stage of maintained anesthesia until 30min before the end of surgery. Anesthesia was induced by propofol, sufentanil and cisatracurium in the four groups. It was done by the same operator with downlink Shikani trachea cannula. Anesthesia was maintained by propofol, remifentanil or dexmedetomidine to control Narcotrend NI value in the range of D. Cisatracurium was added According to the needs of operation. All patients were given postoperative analgesia pump for 48h’s PCIA, analgesic time. The patients’value of NI, HR, MAP, SBP, DBP, SPO2 and PetC02 was recorded in the time of T1(in the operating room), T2(30min before EA/TEAS or 10min after the time of pumping dexmedetomidine), T3(after EA/TEAS or pumping dexmedetomidine), T4(after anesthesia induction), T5(the time of intubating), T6(5min after intubation/before pneumoperitoneum), T7(cut the skin instantly), T8 (the time to start establish pneumoperitoneum), T9(10min after pneumoperitoneum), T10(30min after pneumoperitoneum), T11(the end of pneumoperitoneum), T12(the end of the surgery), T13(before the second practice of EA/TEAS), T14(after the second practice of EA/TEAS), T15(the time to leave the operating room) after the their getting to the operating room. The score of VAS on the surgery day and on the first day after surgery was recorded as well as the anesthetic dosage, the first postoperative exhaust time, the numerical ofSOD, GSH-Px at the time of T1, T6,T11, T14 and T16.ResultsThere’s no patient found having severe anxiety or depression or there’s no statistical difference (P>0.05) in preoperative SAS, SDS score. There were no significant difference (P>0.05) in general information of four groups. There’s no statistical difference (P>0.05) in Anesthesia time, operating time or pneumoperitoneum time. The GSH-Px value of group C at T6, T11, T14 is significantly lower than that at T1(P <0.05). The GSH-Px value of group E at T11 time is significantly lower than that at T1 (P<0.05). The GSH-Px values of group D at T6 and T11 is significantly lower than the value at T1 (P<0.05). The GSH-Px value of group T at T6 and T11 are significantly lower than that at T1(P<0.05). There may be some mistakes in the process of experiment, which make the value of SOD significantly lower than the SOD value in the plasma, so that it makes no sense. There’s no statistical difference (P>0.05) of the VAS score in the first postoperative exhaust time in all patients.ConclusionLaparoscopic surgery will weaken the body’s ability to resist oxidative stress. The transcutaneous acupoint electrical stimulation, dexmedetomidine and electric acupuncture can not increase GSH-Px value. This study not found that EA and TEAS stimulation patients can shorten the postoperative first exhaust time. |
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