静脉全麻中经皮穴位电刺激的镇痛效应测定

目的探讨经皮穴位电刺激在静脉全身麻醉乳腺手术中的镇痛效应。方法100例患者随机分为实验组及对照组,两组患者均采用异丙酚-瑞芬太尼靶控输注静脉全身麻醉。实验组在麻醉前30min采用韩氏穴位神经刺激仪(HANS)和2/100Hz疏密波,经皮肤电极持续刺激手术侧合谷和内关穴直至手术结束。以抑制50%手术切皮体动反应的瑞芬太尼血浆浓度(ED50)、术中心率、血压变化及异丙酚和瑞芬太尼消耗量作为评价指标。结果经皮穴位电刺激可使瑞芬太尼切皮时血浆靶浓度ED50减少0.33ng/ml,约降低14.3%。在乳腺手术中可减少丙泊酚用量17%、瑞芬太尼用量26%。结论丙泊酚-瑞芬太尼静脉麻醉中复合经皮穴位电刺激能够加强麻醉镇痛作用,明显减少术中丙泊酚及瑞芬太尼用量。

The analgesia effect of transcutaneous electrical acupoint stimulation during intravenous anesthesia

Objective To study the analgesia effect of transcutaneous electrical acupoint stimulation(TEAS) for intravenous anesthesia during breast operation. Methods One hundred patients were randomly divided into experimental group and control group,with 50 cases in each group.The experimental group choosed the following modus: hegu acupoint and neiguan acupoint, sparse-dense wave(2/100 Hz),stimulating continually for 30 minutes before anesthesia induction with propofol and remifentanil intravenous infusion. TEAS were continuous during the operation. Results TEAS reduced 14.3% of the ED50 of remifentanil plasma target concentration in skin-cutting. TEAS can reduce the requirement of propofol by 17% and remifentanil 26% during breast operation. Conclusion TEAS has some anesthetic effect during combined anesthesia with propofol and remifentanil,and it can significantly reduce the requirement of propofol and remifentanil during breast operation.