经皮穴位电刺激辅助全麻对乳腺癌根治术中镇痛效应和血流动力学的影响

目的 观察经皮穴位电刺激（TEAS）辅助全麻下对乳腺癌根治术中镇痛效应和血流动力学的影响。方法 选取来自温州医科大学附属第一医院2019 年7 月～2020 年2 月全麻下行乳腺癌根治术患者80 例,按随机数字表法随机分成两组：TEAS 组和对照组,每组各40 例。TEAS 组在麻醉诱导前30 min 行TEAS（取穴为双侧合谷、内关、足三里、三阴交）,直至手术结束。对照组予相同位置贴电极片,不予电刺激处理。两组患者均采用常规诱导后置入喉罩全麻。记录两组术中各时间点的MAP、HR 和脑电双频谱值（BIS）、拔管时间、术中麻醉用药情况。结果 两组患者的一般情况和手术情况无差异。TEAS 组的拔管时间较对照组缩短,术中瑞芬太尼用量减少（P＜0.05）;TEAS 组在插管后即刻（T1）、插管后5 min（T2）、拔管后即刻（T6）、拔管后3 min（T7）的MAP 水平显著低于对照组（P＜0.05）,TEAS 组在插管后即刻（T1）、插管后5 min（T2）、拔管后即刻（T6）的HR 水平显著低于对照组（P＜0.05）;TEAS 组的T1 时刻BIS 值显著低于对照组（P＜0.05）。结论 经皮穴位电刺激辅助全麻可以增强乳腺癌根治术中镇痛效应,减轻术中应激反应。

Impacts of transcutanclus electrical acupoint stimulation assisted general anesthesia on analgesia and hemodynamics in radical mastectomy

Objective To observe the impacts of transcutanclus electrical acupoint stimulation(TEAS) assisted general anesthesia on analgesia and hemodynamics in radical mastectomy.Methods 80 patients with breast cancer undergoing radical mastectomy under general anesthesia from July 2019 to February 2020 in the First Affiliated Hospital of Wenzhou Medical University were divided into the TEAS group(n=40) and the control group(n=40) according to the random number table method.In the TEAS group,TEAS was performed 30 minutes before induction of anesthesia (taking acupoints at bilateral He Gu,Nei Guan,Zu San Li and San Yin Jiao) until the end of operation.In the control group,electrode patches were attached at the same position without electrical stimulation.Two groups of patients were given general anesthesia with laryngeal mask after conventional induction.MAP,HR,BIS pectral value(BIS),extubation time,and anesthesia medication during operation were recorded in both groups.Results There was no difference in general condition and operation condition between the two groups.Compared with the control group,the extubation time of the TEAS group was shorter,and the dosage of fentanyl was decreased during the operation(P<0.05).The MAP immediately after intubation(T1),5 min after intubation(T2),6 min after extubation(T6) and 3 min after extubation(T7) in the TEAS group was significantly lower than those in the control group(P<0.05).Meanwhile,the HR of TEAS group immediately after intubation(T1),5 min after intubation(T2) and 6 min after extubation(T6) was significantly lower than that in the control group(P<0.05).BIS value of the TEAS group at T1 was significantly lower than that of the control group(P<0.05).Conclusion TEAS assisted general anesthesia can enhance the analgesic efficacy during radical mastectomy and reduce the stress reaction during operation.