The Effect Of Transcutaneous Electrical Acupoint Stimulation On Analgesia And Stress Response In Patients Undergoing Laparoscopic Surgery

Background:Laparoscopic surgery is widely practiced in clinical practice due to its small trauma,light pain,and rapid postoperative recovery.Artificial pneumoperitoneum in laparoscopic surgery will clear the field of vision,but on the other hand will increase the stress response.Although many anesthetics are clinically effective in suppressing stress,the use of excessive anesthetics can have additive or accumulation effects that can adversely affect.Studies have shown that Transcutaneous Electrical Acupoint Stimulation(TEAS)not only has an analgesic effect,but also reduces stress response and reduces postoperative complications.However,there are few studies on the analgesic and stress response effects of TEAS in laparoscopic surgery.Therefore,the role of TEAS in laparoscopic surgery is of great significance for further promotion of anesthesia applications.Objecyive:To investigate the analgesic effect of TEAS Sanyinjiao and Hegu acupoint assisted general anesthesia in laparoscopic surgery and its effect on intraoperative stress response,and to explore its clinical application value.Methods:A randomized controlled trial,single-blind design study,64 patients who met the criteria were randomly divided into the control group(32 cases)and the experimental group(32 cases).Experimental group:10 minutes before induction of anesthesia,4 acupoints of bilateral Sanyinjiao and Hegu were selected,and the patient was subjected to electrical stimulation at a frequency of 2-100 Hz.The intensity was based on the maximum intensity that the patient could tolerate(no more than 5 mA).),and maintained until the surgery;control group:connected electroacupuncture,no electrical stimulation,the same experimental group.The drug anesthesia of the two groups:midazolam 1-2mg,long toning 0.01mg/Kg,cis-atracurium 0.2mg/kg,target-controlled infusion of propofol 4ug/ml according to plasma concentration,Remifen Tai Ni 5ng/ml,tracheal intubation after 3-4min.After tracheal intubation,the amount of propofol was adjusted according to the bispectral index(BIS)to maintain the BIS value between 40 and 60,and the cyclic fluctuation did not exceed 30%of the baseline value;according to the index of consciousness 2,IoC2)value to adjust the dosage of remifentanil,m aintaining IoC2 value between 40-50.Stop the propofol and remifentanil infusion when the pneumoperitoneum is closed.The weight and age of the general data of the two groups were recorded;blood pressure,heart rate(HR)and blood glucose(10 min before anesthesia induction,10 min before gastro-intestine(T1),10 min after pneumoperitoneum(T2),and at the end of surgery(T3).Glu);total amount of propofol and remifentanil in the operation;anesthesia time,extubation time;VAS score of patients before and after anaesthesia;and number of vomiting cases in the two groups.Results:There were no significant differences in general data and MAP,heart rate,and blood glucose between the two groups(p>0.05).The MAP and heart rate of the two groups were lower at T1,T2 and T3 than those at TO.The time points of T1,T3 and T1,T2 and T3 in the control group were statistically significant(p<0.05).The MAP and heart rate groups in the group were lower than those in the control group at the T1,T2,and T3 time points.The difference in MAP between the T2 time points was statistically significant(p<0.05),and the difference between the T2 and T3 time snack rates was statistically significant.Significance(p<0.05).The blood glucose level of the two groups was lower than that of T0.The T1 time point of the control group was decreased,the difference was statistically significant(p<0.05),and the T2 and T3 time points were increased.The difference was not statistically significant(p>0.05).The experimental group T1,T2 The time points of T3 decreased,and the difference was statistically significant at T1(p<0.05).Compared with the control group,the T1,T2,and T3 time points were lower than the control group,and the difference between T2 and T3 time points was statistically significant.Significance(p<0.05).The VAS score VAS score in the experimental group was lower than that in the control group 1 hour after extubation,and the difference was statistically significant(p<0.05).The doses of propofol and remifentanil and the number of postoperative vomiting in the two groups were lower in the experimental group than in the control group(p<0.05).There was no significant difference in anesthesia time and extubation time between the two groups(p>0.05).Conclusion:Compared with general anesthesia,TEAS Sanyinjiao and Hegu acupoints can inhibit intraoperative stress,reduce the use of propofol and remifentanil,reduce the incidence of postoperative vomiting,and have better analgesic effect.Therefore,it has clinical application value.