Objective To observe the effect of electroacupuncture combined with general anesthesia on the stress response of patients with open posterior lumbar spine surgery.
Methods A total of 180 patients who scheduled for open posterior lumbar spine surgery, 68 males and 112 females, aged 18-70 years, ASA physical status Ⅰ or Ⅱ, were randomly divided into three groups (n = 60 in each group): electroacupuncture group (group A), non-acupoint group (group B) and the control group (group C). Before the induction of anesthesia, group A was treated with electroacupuncture at bilateral Hegu (LI4) and Neiguan (PC6) for 30 minutes, group B was treated with electroacupuncture at non-acupoints on the upper limb for 30 minutes, group C was not given any electroacupuncture stimulation. The anesthesia methods in the three groups were the same, and patient-controlled intravenous analgesia (PCIA) was performed after the operation. The intraoperative dosage of propofol and remifentanil, and the cumulative dosage of PCIA within 24 hours and 48 hours after surgery were recorded. HR and MAP were recorded before electroacupuncture treatment (T0), before anesthesia induction (T1), immediately after tracheal intubation (T2), during incision (T3), and at the end of suture (T4). The concentrations of epinephrine (E), norepinephrine (NE), dopamine (NA), cortisol (Cor), and blood glucose were measured at T0, T3, and T4.
Results The intraoperative dosage of remifentanil in group A was lower than that in group B, and the dosage of PCIA analgesics within 48 hours after surgery was lower than that in the other two groups (P < 0.05). Compared with T0, the HR and MAP were significantly higher in groups A and C at T2 and T3 and in group B at T2(P < 0.05). HR in group B was higher than that in group A at T1, lower than that in groups A and C at T3. MAP in groups A and B was significantly lower than that in group C at T2 and T3(P < 0.05). The concentration of E in group A was significantly lower than that in groups B and C at T4, and the concentration of DA in group A was lower than that in group C at T3. Compared with T0, Cor and blood glucose concentrations in the three groups at T3 and T4 were significantly increased (P < 0.05). The concentration of Cor in group A at T3 and T4 and Cor in group B at T4 were lower than that in group C (P < 0.05).
Conclusion Electroacupuncture combined with general anesthesia is beneficial to maintain perioperative hemodynamic stability in patients with open lumbar posterior surgery, reduce acute stress response and the amount of anesthetic analgesics. Compared with non-acupoints, electroacupuncture combined with general anesthesia has better effect. |
