The Electrophysiological Mechanism Of TEAS On Neiguan Point Ameliorating Bradycardia Induced By Dexmedetomidine

Objective:To observe the effect of transcutaneous electrical acupoint stimulation at Neiguan point on PR interval,QT interval,Tp-e interval and electrophysiological balance index(iCEB)when injecting dexmedetomidine in patients undergoing gynecological operation,and to explore its electrophysiological mechanism in improving bradycardia induced by dexmedetomidine.Methods:From November 2019 to December 2019,60 patients planned elective general anesthesia for gynecological surgery,aged 20-50 years,ASAI-Ⅱ,BMI 18.5-24,were divided into two groups(n=30)according to the random number table:Dexmedetomidine group(D group)and transcutaneous electrical acupoint stimulation on Neiguan point combined with Dexmedetomidine group(N Group).After entering the operating room,the vital signs were routinely monitored,the patients in D group were injected 1μg/kg of dexmedetomidine for 10min,stick the electrode piece on Neiguan point and connect the therapeutic apparatus,but not stimulate.In group N,the same dose of dexmedetomidine were injected and Neiguan acupoint was taken for transcutaneous electrical acupoint stimulation at the same time.ECG was collected before the injection of demedetomidine(To)and 10 minutes after the injection of dexmedetomidine(T1).PR interval,QT interval,Tp-e interval,index of cardiac electrical balance(iCEB)were measured in the two groups.The occurrence of arrhythmia was observed and recorded during the study.Results:1.Comparison of heart rate:compared with T0,HR of the two groups was decreased at T1(P<0.05);Compared with D group,HR of N group was increased at T1(P<0.05).2.Comparison of electrophysiological indexes:compared with T0,QT interval and PR interval were prolonged(P<0.05)in both groups,iCEB was increased and Tp-e was prolonged in D group(P<0.05)at T1.Compared with D group,PR interval and Tp-e interval in group N were shortened(P<0.05)at T1.3.Comparison of the incidence of arrhythmia compared with D group,the incidence of bradycardia and atrioventricular block in N group was reduced(P<0.05).Conchusion:Transcutaneous electrical acupoint stimulation on Neiguan point can improve bradycardia caused by dexmedetomidine by shortening atrioventricular conduction time and reducing repolar heterogeneity.