Effects Of Transcutaneous Electrical Acupoint Stimulation On Stress Response During Extubation Period In Patients Undergoing Thoracoscope Pneumoresection

ObjectivesTranscutaneous electrical acupoint stimulation?TEAS?,which combines physiological effects,acupuncture stimulation and electrotherapy,relies on intensity and frequency to regulate physiological functions has been proved special effects in relieving pain,enhancing immunity,and relieving stress.To investigate whether TEAS can reduce adverse stress during catheterization in patients who underwent ventilation with a double lumen tube?DLT?,TEAS was designed to be used in patients undergoing thoracoscopic surgery before and during surgery in this study to explore the effects of TEAS to autonomic stress before and after the removal DLT.MethodsAccording to the screening criteria and exclusion criteria,a total of 84 eligible participants with the consent of the subjects and their families were enrolled in the patients who underwent thoracoscopic lung surgery under the general anesthesia of Tangshan People's Hospital during the period from November of 2017 to March of 2018.There were46 males and 38 females,aged 30⁶8 years,and ASAI^II.All subjects were randomly divided into electrical stimulation group?T group,n=42?and sham stimulation group?S group,n=42?.30 minutes before the induction of anesthesia,all patients in the acupoints of Neiguan?PC6?,Hegu?LI4?,Lieque?LU7?,and Chize?LU5?of bilateral forearm were affixed to the electrode sticker.The T group was connected to the HANS200 stimulator and received electrically stimulated.The electrode were attached to the target acupuncture point in the S group,the wire was fixed to the electrode with tape but not connected.The patient's baseline mean arterial pressure?MAP?and heart rate?HR?were recorded after the patient was connected to the monitoring device?since 5 minutes after entering the room,T₁?,so were the time of drug injection induction?T₂?,removal of DLT immediately?T₃?,5min?T₄?and 10 min?T₅?after removal of DLT.Blood samples were taken at T₁^T₅ to detect concentrations of epinephrine?E?,norepinephrine?NE?and cortisol?COR?.Results There were no significant differences in gender,ASA classification,lung side of the operation,pathological findings of benign and malignant,age,weight,and laparoscopic surgery time between the two groups,P>0.05.There were no significant difference winthin two groups between the vital signs and the plasma stressor concentrations measured in the baseline of entering the room and T group?experimental group?after 30 minutes of electrical stimulation?ie,before induction?,P>0.05;In the group T and S,the MAP at the time of removal DLT was significantly higher than that of basal level at entering the room,and the HR?only rhythm changes,no arrhythmia was found?increased significantly,that is the blood pressure and heart rate of the two groups at T₃ were higher than those at T₁,P<0.05.The vital signs of T group showed significant decline after T₃,there was no significant difference of vital signs parameters between T₄^T₅ and T₁,P>0.05.The hemodynamics of group S remained at a high level for at least 10 minutes in a short time,and was higher than the basicline value.The MAP and HR of S group were significantly higher in T₄^T₅ stage than that at T₁,P<0.05.The MAP index during T₃^T₅ in group T was significantly lower than that in S group,and the recorded HR level was also significantly slowed down,P<0.05.The concentration of E and NE in plasma catecholamines increased significantly relative to the basal level when DLT was removed,and maintained until at least 10 min after extubation.The COR also showed corresponding changes.The concentrations of E,NE and COR measured at T₃^T₅ in both groups were higher than those at T₁,P<0.05.In the 10 minutes after extubation,the measured concentration of stressful substance decreased significantly in T group compared with the S group,P<0.05,the difference was statistically significant.ConclusionsContinuous application of TEAS as Preoperative prophylaxis for general anesthesia and thoracoscopic lung surgery does not affect the vital signs and internal stress hormones of unstimulated patients.TEAS is proved beneficial to reduce the drastic fluctuations in apparent vital signs in the period of removal the DLT in this study,maintain the balance of autonomic autonomic responses,reduce the concentration of reactive plasma stress substances such as E,NE,and COR,and improve the safety of extubation.Figure 10;Table 3;Reference 122...