Preventive Effect Of Transcutaneous Acupoint Electrical Stimulation In Treating Postoperative Nausea And Vomiting In Patients Undergoing Craniotomy:Determination Of Plasma Motilin Concentration

Objective Despite useing of antiemetics drugs,but as a common complication after anesthesia and surgery,postoperative nausea and vomiting?PONV?were plagued by anesthesiologists.Large number of clinical studies had shown that TAES Neiguan?PC6?or zhigou?SJ6?could effectively prevent the occurrence of PONV.The incidence of PONV can be reduced by TAES treatment in the craniotomy patients who have a high risk of PONV.However,the effect of combined stimulation of PC6 and SJ6 on the incidence of PONV in patients undergoing craniotomy has not been reported.This article is to observe the effect of PC6 and SJ6 TAES in preventing PONV after craniotomy,and to detect the changes of plasma motilin concentration.Methods A total of 100 American Society of Anesthesiologists physical status I–II patients aged 18-65 years who were scheduled to undergo elective craniotomy for various intracranial lesions were enrolled in this study.The patients were randomly divided into control group?50 cases?and TAES group?50 cases?.All patients underwent intravenous inhalation combined anesthesia and given routine intravenous azasetron hydrochloride 10 mg before the end of operation.When the TAES patients regained consciousness from anesthesia of extubation and were able to communicate with others.In our study,we used the SDZ-II electronic therapy instrument,by which positive electrode was pasted in the bilateral PC6 and SJ6 points while negative electrodes was pasted next to 3 cm.Using 2/100 dilatational wave,the intensity varied until the patients tolerance the maximum stimulus to stimulate 30 min.In the control group,the electrode was attached to the corresponding site,but not stimulated.Blood samples were taken before operation?T₁?,at the end of the operation?T₂?,and 12 h and 24 h after operation?T₃,T₄?.After centrifugation,we took the plasma and stored in a refrigerator at-80?,determination of plasma motilin concentration.The occurrence of PONV was recorded within 2 h after operation,during 2-6 h and 6-24 h after operation,and within24 h after operation.PONV classification?0?????????,for more than grade?or wanted to be treated patients will be given 10 mg metoclopramide.The need for rescue antiemetics were recorded.Finally,normally distributed data were expressed as mean±SD.Data of different groups were analyzed using t test,qualitative data using?²test.Statistical differences were considered significant if the P value was<0.05.Results Among the initial 100 patients,92 completed the study and were included the final analysis,including 47 cases in the control group,45 cases of TAES group.There was no significant difference in the general condition?gender,age,body mass index,smoking history,operation site and time?between the two groups?P>0.05?.The PONV incidences of the control group and TAES group were 55.3%and 33.3%.There was no significant difference in the incidence of PONV at 0-2 h in the two group?P>0.05?.Compared with the control group,the incidence of PONV within 2-6 h,6-24 h,and 24 h after operation were significantly decreased in TAES group?P<0.05?.Compared with the control group,the level of PONV were significantly decreased in TAES group?P<0.05?.The need for rescue antiemetics were 14 patients in control group and 5 patients in TAES group,the difference between the two groups was statistically significant?P<0.05?.The serum concentration of plasma motilin were significantly decreased at T₃ in TAES group?P<0.05?.Conclusions TAES PC6 and SJ6 on the basis of routine treatment ban further decrease the occurrence of PONV in patients undergoing craniotomy,and its mechanism may be related to decreased concentration of the plasma motilin after operation.