The Effect Of Transcutaneous Electrical Acupoint Stimulation On Hepatic Ischemia-reperfusion Injury In Patients Undergoing Hepatectomy

Objective: To investigate the effects of transcutaneous electrical acupoint stimulation(TEAS)Neiguan,Quchi,Zusanli and Sanyinjiao points on hepatic transaminase,inflammatory factors and postoperative nausea and vomiting after hepatic ischemia-reperfusion injury in patients undergoing open hepatectomy.Methods: Forty patients aged 30-65 with American Society of Anesthesiologist(ASA)I-III grade open hepatectomy were randomly divided into experimental group(TH group)and control group(H group)with 20 cases in each group.30 mins prior to the induction of anesthesia,patients in TH group were given TEAS on the bilateral Neiguan,Quchi,Zusanli and Sanyinjiao which continued to the end of the surgery,with the maximum stimulation intensity that the patients could tolerate and the frequency was 2Hz/100 Hz.Patients in H group received no stimulation.The date that has been recorded were including two groups of patients age,gender,weight,ASA status,hepatic occlusion time,operation time,number of resected liver segments,urine volume and blood loss;the MAP and HR when resting(T0),before intubation(T1),skin incision(T2),5 min after hepatectomy(T3)and shortly before the end of operation(T4),as well as the occurrence of adverse circulation events during operation;the groups patients venous blood samples were extracted at time resting(T0),6h(T5),24h(T6)and 48(T7)after reperfusion,to measure and compare the levels of serum Alanine transaminase(ALT),spartate aminotransferase(AST),tumor necrosis factor a(TNF-a)and interleukin-6(IL-6);adverse reactions of nausea and vomiting within 24 hours after operation.Results:(1)There were no significant differences in age,gender,ASA status,weight,hepatic occlusion time,operation time,number of resected liver segments,urine volume and blood loss between the two groups(all P>0.05).(2)At the time points from T0 to T4,there was no significant difference in the changes of MAP?HR and the adverse circulation events between the two groups(P>0.05).(3)At the time of T0,there was no significant difference in serum ALT and AST between the two groups(P>0.05),but the levels of serum ALT and AST in the two groups at each time point of T5-T7 were higher than those in T0.However,the increase in TH group was significantly lower than that in H group,and the difference between the two groups was statistically significant(P<0.05).(4)At the time of T0,there was no significant difference in serum TNF-a and IL-6 between the two groups(P > 0.05),but the levels of serum TNF-a and IL-6 in the two groups at each time point of T5-T7 were higher than those in T0.However,the increase in TH group was significantly lower than that in H group,and the difference between the two groups was statistically significant(P<0.05).(5)The incidence of adverse reactions of nausea and vomiting in TH group was significantly lower than that in control group within 24 hours after operation(P <0.05).Conclusion: The application of TEAS in open hepatectomy can reduce the levels of serum TNF-a and IL-6 inflammatory factors and hepatic transaminase,which may have a certain protective effect on liver injury during ischemia-reperfusion,and it is effective to reduce the occurrence of early postoperative nausea and vomiting.