经皮穴位电刺激复合TCI在全麻中镇痛效应及对心血管系统的影响

目的：探讨经皮穴位电刺激复合靶控输注（TCI）在全麻中镇痛效应及对心血管系统的影响。方法：选择择期行乳腺手术的患者60例，随机分为2组，经皮穴位电刺激复合TCI组（简称复合组）和单纯TCI组（简称TCI组），每组30例。复合组患者先行经皮穴位电刺激麻醉诱导30min，然后行TCI静脉全身麻醉，经皮穴位电刺激持续刺激至手术结束；TCI组单纯行TCI静脉全身麻醉。通过对全麻药血浆靶控浓度的影响，评价经皮穴位电刺激的镇痛效应。同时观察经皮穴位电刺激在术中对患者心血管系统的影响。结果：复合组及TCI组患者术中平均所需的丙泊酚量分别为226．67mg及272．22mg，平均所需的芬太尼量分别为0．11mg及0．14mg，组间差异具有显著性或非常显著性意义（P〈0．05，P〈0．01）；复合组切皮前后心率、血压的波动均较TCI组小，差异具有显著性意义（P〈0．05）；复合组患者苏醒时间明显缩短。结论：经皮穴位电刺激在术中具有一定的麻醉镇痛作用，可相对减少17％丙泊酚用量及14％芬太尼用量；同时，经皮穴位电刺激可以减轻手术切皮对患者所致的心血管系统的应激反应，并可加快患者的苏醒。

Analgesic effect of transcutaneous electrical acupoint stimulation combined with target-controlled infusion in general anesthesia and effects on cardiovascular system

OBJECTIVE: To observe analgesic effect of transcutaneous electrical acupoint stimulation combined with target-controlled infusion (TCI) in general anesthesia and effects on cardiovascular system. METHODS: Sixty selective breast operation patients were randomly divided into a combined group and a TCI group, 30 cases in each group. The combined group received anesthesic induction for 30 min with transcutaneous electrical acupoint stimulation and then TCI into vein for general anesthesia, and the transcutaneous electrical acupoint stimulation was continued till the end of the operation. The TCI group only received TCI irito vein for general anesthesia. The target-controlled concentration of the general anesthesia drugs in plasma was monitored to evaluate the analgesic effect of transcutaneous electrical acupoint stimulation. Meanwhile, the effects of the transcutaneous electrical acupoint stimulation on cardiovascular system were investigated. RESULTS: The mean Propofol and Fentany dosages needed were 226.67 mg and 0.11 mg in the combined group, and 272.22 mg and 0.14 mg in the TCI group during the operation, respectively, with significant differences (P < 0.05 or P < 0.01). The changes of heart rate and blood pressure in the combined group during skin-cutting were significantly less than those in the TCI group (P < 0.05). The awaking time in the combined group was significantly shortened. CONCLUSION: The transcutaneous electrical acupoint stimulation has a certain analgesic effect in the operation and can reduce 17% Propofol dosage and 14% Fentany dosage, and it can decrease the skin-cutting-induced stress reaction of the cardiovascular system and accelerate waking.