Objective: To explore the effect of transcutaneous electrical acupoint stimulation (TEAS) on perioperative analgesia in elderly patients undergoing lumbar fusion internal fixation.
Methods: Eighty-two elderly patients undergoing lumbar fusion internal fixation within two levels, 57 males and 25 females, aged 65-74 years, BMI 18.5-24.0 kg/m2, ASA physical status Ⅰ-Ⅲ, were randomly divided into two groups: TEAS group and control group, 41 patients in each group. Both groups were given tracheal intubation intravenous general anesthesia. TEAS group was treated with TEAS from 30 minutes before anesthesia induction to the end of the operation, and continued TEAS for 2 days after surgery, once a day, 30 minutes once time, and the stimulation sites were bilateral Hegu, Neiguan, and Zusanli. In the control group, the electrodes were only connected at the same time point without electrical stimulation. Both groups were treated with bilateral erector spinae plane block (ESPB) under ultrasound guidance after anesthesia induction. PCIA was performed by connecting the analgesic pump after operation. HR and MAP before stimulation and at the time of skin incision were recorded. The dosage of propofol and remifentanil and the number of sufentanil additions during operation were recorded. The addition rate of sufentanil was calculated. The resting and activity VAS pain scores 2, 4, 8, 12, 24, and 48 hours after operation were recorded. First compression time of analgesic pump, the consumption of sufentanil 48 hours after operation, the ratio of effective pressing times of analgesic pump to actual pressing times (D1/D2), rescue analgesia rate and adverse reactions were recorded.
Results: Compared with control group, HR was slowed down significantly and MAP was decreased significantly at the time of skin incision in TEAS group, the rate of sufentanil additions, the activity VAS scores 2, 4, 8, 12, 24, and 48 hours after operation , the resting VAS pain scores 12, 24, and 48 hours after operation in TEAS group were significantly decreased,the first compression time of analgesic pump was significantly prolonged, the consumption of sufentanil 48 hours after operation was significantly decreased, D1/D2 was significantly increased, the rate of rescue analgesia, nausea and vomiting, dizziness were significantly decreased (P < 0.05).
Conclusion: TEAS can provide better analgesia for elderly patients undergoing lumbar fusion internal fixation, reduce the use of opioids, prolong the postoperative analgesia time and reduce the incidence of postoperative adverse reactions. |
