Objective To investigate the application effect of buccal acupuncture in the laparoscopic cholecystectomy for elderly patients.
Methods Ninety-seven elderly patients for laparoscopic cholecystectomy, 55 males and 42 females, aged 65-74 years, BMI 20-30 kg/m2, ASA physical status Ⅰ-Ⅲ, were randomly divided into two groups by random number table method: control group (n = 48) and acupuncture group (n = 49). The acupuncture group was given buccal acupuncture before induction of anesthesia, and the needle was performed every 5 minutes for the entire operation period. The control group was not be treated with buccal acupuncture. MAP and HR were recorded at the time when the patient entered the operating room (T0), 5 minutes after anesthesia (T1), skin incision (T2), 5 minutes after airway catheter removal (T3), 6 hours after surgery (T4), and 24 hours after surgery (T5). The dosage of intraoperative propofol and remifentanil were recorded. Venous blood samples were collected at T0 and T5, and plasma levels of C-reactive protein (CRP), cortisol (Cor), blood glucose and lactic acid were measured. The time when the patient first experienced pain after surgery, the proportion of additional analgesia required within 24 hours after surgery, the incidence of postoperative nausea and vomiting (PONV), and the incidence of postoperative shoulder discomfort were recorded.
Results MAP and HR in the acupuncture group were significantly lower than those in the control group at T2 and T4 (P < 0.05). The intraoperative dosage of propofol and remifentanil in the acupuncture group were significantly lower than those in the control group (P < 0.05). Compared with T0, the plasma levels of CRP, Cor, blood glucose, and lactate acid in the control group were significantly increased at T5, while the blood glucose concentration in the acupuncture group increased significantly at T5(P < 0.05). The levels of CRP, Cor and lactic acid in the acupuncture group were significantly lower than those in the control group at T5 (P < 0.05). The time of postoperative pain in control group appeared significantly earlier, and the proportion of additional analgesia needed was also significantly increased than that in the acupuncture group (P < 0.05). The incidence of PONV and shoulder discomfort in the acupuncture group was significantly less than that in the control group (P < 0.05).
Conclusion The application of buccal acupuncture in laparoscopic cholecystectomy for elderly patients can help to relieve pain during and after the operation, and reduce stress response. It can be used as an auxiliary method for anesthesia in elderly patients with LC. |
