Effect of transcutaneous auricular vagus nerve stimulation on tourniquet-induced hypertension in patients undergoing anterior cruciate ligament reconstruction
10.3760/cma.j.cn131073.20231206.00304
- VernacularTitle:经耳迷走神经刺激对前交叉韧带重建术患者止血带相关高血压的影响
- Author:
Qi ZHOU
1
;
Mingyang GAO
;
Lili YU
;
Yanan LI
;
Xuguang CHEN
;
Peixia YU
;
Yahui ZHANG
;
Jiangtao DONG
;
Qiujun WANG
Author Information
1. 河北医科大学第三医院麻醉科，石家庄 050051
- Keywords:
Ear;
Vagus nerve stimulation;
Anterior cruciate ligament reconstraction;
Tourniquets;
Hypertension
- From:
Chinese Journal of Anesthesiology
2024;44(3):272-276
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of transcutaneous auricular vagus nerve stimulation (taVNS) on tourniquet-induced hypertension (TIH) in the patients undergoing anterior cruciate ligament reconstruction.Methods:Seventy-four patients of either sex, aged 18-60 yr, of American Society of Anesthesiologists Physical Status classification I or II, with body mass index of 18-30 kg/m 2, undergoing elective anterior cruciate ligament reconstruction under general anesthesia combined with preoperative femoral nerve block, were divided into 2 groups ( n=37 each) using a random number table method: sham stimulation group (group SS) and group taVNS. Group SS received stimulation on the ear lobe and the tail of the helix of the left ear. Group taVNS received stimulation on the cymba concha and the earlobe of the left ear. Both groups received stimulation from 1 h before induction of anesthesia until the end of the procedure (frequency of 30 Hz, pulse width of 300 μs, and amplitude of the strongest current that could be tolerated by the patient in the absence of pain). The tourniquet inflation pressure was 280 mmHg, with an inflation time of 60-90 min. Systolic blood pressure, diastolic blood pressure and heart rate were recorded before tourniquet inflation to assess the development of intraoperative TIH. The consumption of intraoperative propofol, remifentanil, nitroglycerin, esmolol, norepinephrine and atropine was recorded, and the occurrence of postoperative nausea and vomiting, skin itching and headache and dizziness was also recorded. Results:Compared with group SS, the incidence of TIH and the number of patients used nitroglycerin were significantly reduced ( P<0.05), and no significant changes were found in the other parameters in group taVNS ( P>0.05). Conclusions:taVNS can decrease the occurrence of TIH in the patients undergoing anterior cruciate ligament reconstruction.
