The Effect Of Transcutaneous Electrical Stimulation At Dazhui Point On Hemodynamic In Combined Spina-Epidural Anesthesia In Elder

Objective: The aim of the study is to investigate the effect of transcutaneous electrical stimulation at dazhui point on hemodynamic in combined spina-epidural anesthesia in elder.Method: Sixty patients(ASAI~II) aged 55~75 years old, BMI<28, undergoing unilateral total hip replacement were randomly assigned to three groups(n=20, respectively). In group A, all patients recived a continuously transcutaneous electrical stimulation at dazhui point with ferquency of 16 HZ and power of 10 V for 10 minutes before combined spina-epidural anesthesia. The stimulation were kept during the operation. In group B, all patients choose the same point as group A, but not electric stimulation, 10 minutes later combined spina-epidural anesthesia. In group C, all patients recived a continuously transcutaneous electrical stimulation beside developing under the lateral thoracic spine 9 5 inches, the attachment, stimulation intensity, frequency, stimulate time same to group A, 10 minutes later combined spina-epidural anesthesia.(1) Monitored the changes of hemodynamic indicators of SBP?DBP?MAP?HR and SpO2 at intervals before anesthesia(T0), 5 minutes(T1), 15 minutes(T2) and 1 hour(T3) after anesthesia,(2) Observed the change of Hb and Hct before and after surgery.(3) Record the use of phenylephrine.(4) Record infusion?blood loss and urine output.Results:(1)Compared with T0, the SBP?DBP?MAP decreased significantly at T1 in three groups(p<0.05); Compared with T1, the SBP?DBP?MAP decreased at T2 in three groups(p<0.05); Compared with group B and C, the reduction of SBP?DBP?MAP in group A is smaller at T2 and T3(p<0.05); Compared with group B and C, the SBP?DBP?MAP of group A is higher at T3(p<0.05); There was no significant difference of SBP?DBP?MAP between group B and group C at different time(p>0.05).(2)There was no significant difference of HR?SpO2 between groups at different time(p>0.05).(3)The use of phenylephrine in group A is lower than group B and group C(p<0.05). There was no significant difference between group B and group C(p =0.08).(4)There was no significant difference between the three groups in infusion?blood loss and urine output(p =0.09).And there was no significant difference between the change of Hb and Hct% before and after surgery(p>0.05).Conclusion:Transcutaneous electrical stimulation at dazhui point can balance the hemodynamic in combined spina-epidural anesthesia in elder, it can increase the stability of circulation and improve the safety in elder undergoing unilateral total hip replacement combined spina-epidural anesthesia.