Effect Of Transcutaneous Electrical Acupoint Stimulation On Intraoperative Remifentanil Dosage In Patients Undergoing Thoracoscopic Resection Of Lung Cancer

Objective:To explore the effect of Transcutaneous Electrical Acupoint Stimulation（TEAS）on the intraoperative dosage of remifentanil in patients undergoing thoracoscopic resection of lung cancer.Methods:58 American Society of Anesthesiologists physical statusⅠorⅡpatients of both sexes,aged 35～65 years old,with body mass index of18.5-23.5kg/m²,scheduled for thoracoscopic resection of lung cancer,were randomized into 2 groups using a random number table method:transcut-aneous electrical acupoint stimulation group（group E,n=29）and control group（group C,n=29）.After they entered the operation room,an upper limb venous access was established.The electrocardiogram（ECG）,saturation of pulse oximetry（SpO2）,invasive arterial pressure and patient state index（PSI）were monitored.In group E,the bilateral Neiguan and Shenmen acupoints were wiped with alcohol,then the electrodes were attached to the Han’s electrical stimulator,and the acupoints were stimulated 30 min before anesthesia induction until the end of the operation.The stimulation frequency was set to 2/100 Hz.The intensity of stimulation was regulated from weak to strong.When the patient had a sense of"Qi Gan"at the stimulation,the stimulation intensity is gradually adjusted to the maximum tolerance value of the patient（6-10 m A）.In group C,the electrodes were also placed in the same position,but no current stimulation was given.PSI,SpO2,HR and mean arterial pressure(（Mean Arterial Pressure,MAP）were recorded 30 minutes before operation（T0）,before endotracheal intubation（T1）,after endotracheal intubation（T2）,during skin incision（T3）,during one-lung ventilation（T4）,15 minutes after one-lung ventilation（T5）,30 minutes after one-lung ventilation（T6）,1 hour after one-lung ventilation（T7）and at recovery of two-lung ventilation（T8）.At the same time,the total amount of remifentanil,sufentanil and sevoflurane during the operation,and whether the skin of the patient with electrical stimulation had complications such as redness,swelling,damage and burn were recorded.Results:1.There was no significant difference in gender,age,height,weight,BMI and operation time between the two groups（P>0.05）.2.There was no significant difference in the difference between PSI and T0 at each timsignificant difference in the difference of HR,SpO₂,MAP and T₀between the two groue point between the two groups（P>0.05）.3.There was no ps at each time point（P>0.05）.4.Compared with Group C,the total dosage of remifentanil was significantly decreased in Group E.（P<0.05）,but there was no significant difference in the total comsumption of sufentanil and sevoflurane between the two groups（P>0.05）.Conclusions:From 30min before anesthesia to the end of operation,transcutaneous electrical stimulation of bilateral Neiguan and Shenmen acupoints in patients undergoing thoracoscopic lung cancer resection can tolerate the maximum current,which can reduce the dosage of remifentanil,when there is no statistical difference in HR,SpO2,MAP and PSI between the two groups,so it can be safely and effectively used in clinic.