针药复合麻醉的新思路——经皮穴位电刺激参与全麻行控制性降压中对器官保护的可行性

在特定手术全麻中需实施控制性降压,在全麻行不同目标控制性降压的同时有可能会导致脑、心、肝、肾、胃肠等脏器不同程度的损伤,它可能是由在降压期间的低灌注和升压后的再灌注及由此引发的组织灌注和氧代谢失衡所致。单纯的针刺麻醉目前已走向针药复合麻醉,经皮穴位电刺激已作为针麻的主要手段。已证实针灸具有保护脑、心、肝、肾等重要器官的作用,针刺镇痛与血压调控又存在中枢相关性;经皮穴位电刺激配合全麻行异氟醚控制性降压,在降压期间组织氧代谢和循环系统更加稳定。由于颅脑和大关节置换手术的增多,经皮穴位电刺激参与全麻行控制性降压发挥对器官的保护作用,将有很好的应用前景。

New Trains of Thoughts about Compound Anesthesia of Acupuncture Combined with Drugs——an Applicability of Transcutaneous Acupoint Electrical Stimulation

During general anesthesia for some specific surgical cases which need to lower blood pressure,hypotension induced lower blood-perfusion of tissues and the subsequent blood pressure-raising and reperfusion may induce an imbalance between tissue perfusion and oxygen metabolism,probably leading to different degrees of injury of the brain,heart,liver,gastrointestinal tract,etc..Nowadays,simple acupuncture anesthesia has been become into compound anesthesia of acupuncture and drugs,and transcutaneous electrical acupoint stimulation(TEAS)has been already used as one principal measure for acupuncture anesthesia.It has been demonstrated that acupuncture stimulation has a protective effect on the important organs as brain,heart,liver,kidney,etc.,and there exists a central dependability between acupuncture analgesia and blood pressure regulation.In addition,it has been found that during controlled lowering of blood pressure by TEAS in combination with isoflurane general anesthesia,both oxygen metabolism in tissues and performance of the circulation system are rather stable.Along with the increasing of cranial operation and major-arthroplasty,TEAS which possesses important organ protective effect during controlled-blood pressure lowering under general anesthesia has a good applicable prospect.