1.Effect of electroacupuncture preconditioning on emergence agitation in patients undergoing total laparoscopic hysterectomy
Mintao ZHOU ; Caiju ZHANG ; Jinhou FU ; Jinqian HE ; Qianying QI ; Ning SUN ; Bitan ZHANG
Chinese Journal of Anesthesiology 2024;44(11):1307-1310
Objective:To evaluate the effect of electroacupuncture preconditioning on emergence agitation in the patients undergoing total laparoscopic hysterectomy.Methods:This was a randomized controlled trial. Ninety American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ patients, aged 40-60 yr, with a body mass index of 50-70 kg, scheduled for elective total laparoscopic hysterectomy, were divided into control group (C group) and electroacupuncture preconditioning group (E group) using a random number table method, with 45 patients in each group. At 30 min before anesthesia induction, Zusanli and Neiguan acupoints were stimulated for 30 min with disperse-dense waves at a frequency of 2 Hz/100 Hz, an intensity of 3 mA, in group E. Group C did not receive electroacupuncture treatment. The occurrence of emergence agitation, usage of vasoactive drugs and rescue analgesia were recorded in two groups. Peripheral venous blood samples from the upper extremity were obtained before electroacupuncture stimulation (T 0) and at 2 h after operation (T 1) for determination of the plasma concentrations of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) by enzyme-linked immunosorbent assay. Results:The plasma CRP and TNF-α concentrations in group C and plasma IL-10 concentrations in group E were significantly higher at T 1 than at T 0 ( P<0.05). Compared with group C, the usage rate of vasoactive drugs, rate of rescue analgesia, and incidence of emergence agitation were significantly decreased, and the plasma concentrations of CRP and TNF-α were decreased and the plasma IL-10 concentrations were increased at T 1 in group E ( P<0.05). Conclusions:Electroacupuncture preconditioning can decrease the occurrence of emergence agitation in the patients undergoing total laparoscopic hysterectomy, which may be related to inhibiting inflammatory responses.
2.Effect of electroacupuncture pretreatment on the quality of recovery in the patients undergoing laparoscopic gastrointestinal surgery.
Panli ZHOU ; Caiju ZHANG ; Mintao ZHOU ; Jinhou FU ; Jinqian HE ; Ning SUN ; Weifu CAO
Chinese Acupuncture & Moxibustion 2024;44(12):1377-1382
OBJECTIVE:
To investigate the effect of electroacupuncture pretreatment on the quality of recovery in the patients undergoing laparoscopic gastrointestinal surgery.
METHODS:
Sixty patients for elective laparoscopic resection of gastrointestinal tumors under general anesthesia were randomly assigned to either an observation group or a control group, with 30 patients in each group. In the control group, the routine inhalation-intravenous combined general anesthesia was adopted. On the basis of the control group, in the observation group, 30 min before anesthesia induction, electroacupuncture was applied to bilateral Neiguan (PC 6) and Neimadian (Extra) for 30 min, using disperse-dense wave and at 2 Hz/100 Hz. The recovery time of spontaneous breathing, awakening time, extubation time, and the post-anesthesia care unit (PACU) stay time were compared between the two groups. Mean arterial pressure (MAP), heart rate (HR), and oxygen saturation (SpO2) were recorded at multiple time points: before electroacupuncture (T0), before extubation (T1), immediately after extubation (T2), 5 minutes (T3) and 10 minutes (T4) after extubation, and upon discharge from PACU (T5). The visual analogue scale (VAS) score for pain and Ramsay sedation score at T3, T4 and T5 were observed; and the incidence of agitation, nausea and vomiting at T5 was evaluated in the two groups. At T0 and T5, the serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and cortisol were determined in the two groups.
RESULTS:
In the observation group, the recovery time of spontaneous breathing, awakening time, extubation time, and PACU stay time were shorter (P<0.001), MAP and HR at T2 were lower (P<0.01, P<0.05), the VAS scores for pain at T3, T4, and T5 dropped (P<0.001, P<0.01), and the Ramsay sedation score at T3 reduced (P<0.05) compared with those in the control group. The incidence of nausea and vomiting was lower in the observation group when compared with that in the control group (P<0.05). In comparison with the indexes at T0, the serum levels of TNF-α, IL-6, and cortisol increased at T5 in both groups (P<0.01); and these indexes at T5 in the observation group were lower than those in the control group (P<0.01, P<0.05).
CONCLUSION
Electroacupuncture pretreatment can enhance the quality of recovery in the patients undergoing laparoscopic gastrointestinal tumor surgery, shorten the time for spontaneous breathing recovery, awakening, extubation and PACU stay, and attenuate postoperative pain and stress response.
Humans
;
Electroacupuncture
;
Female
;
Male
;
Middle Aged
;
Laparoscopy
;
Adult
;
Aged
;
Anesthesia Recovery Period
;
Interleukin-6/blood*
;
Pain, Postoperative/therapy*
;
Tumor Necrosis Factor-alpha/blood*
;
Young Adult
;
Gastrointestinal Neoplasms/therapy*
;
Acupuncture Analgesia
3.Effect of electroacupuncture preconditioning on cellular immune function in patients undergoing thyroid surgery
Caiju ZHANG ; Xiaoyu DONG ; Mintao ZHOU ; Jinhou FU ; Jinqian HE ; Qianying QI ; Ning SUN ; Bitan ZHANG ; Lei MA
Chinese Journal of Anesthesiology 2023;43(11):1303-1306
Objective:To evaluate the effect of electroacupuncture preconditioning on cellular immune function in the patients undergoing thyroid surgery.Methods:Sixty-six patients of either sex, aged 30-55 yr, with body mass index of 18.5-23.9 kg/m 2, of American Society of Anesthesiologists Physical Status classification ⅠorⅡ, were selected and divided into electroacupuncture preconditioning group (group D) and control group (group C) by a random number table method, with 33 cases in each group. Patients in both groups received combined intravenous-inhalational anesthesia. Before anesthesia induction, both Hegu and Neiguan acupoints were stimulated for 30 min using a continuous wave at a frequency of 2/100 Hz, and the stimulation intensity was subjected to patient tolerance in group D. Group C received sham electroacupuncture for 30 min without stimulation. Venous blood samples were collected at 30 min before anesthesia induction (T 0) and 12, 24 and 48 h after anesthesia (T 1-3). The percentages of T lymphocyte subsets (CD3 +, CD4 +, CD8 +, CD4 + /CD8 + ) and natural killer cells and concentrations of interleukin-6 and tumor necrosis factor-alpha in the serum were measured by flow cytometry. Results:Compared with group C, the percentage of CD3 +, CD4 + and natural killer cells and ratio of CD4 + /CD8 + were significantly increased at T 1, 2, and the concentrations of interleukin-6 and tumor necrosis factor-alpha in the serum were decreased at T 1-3 in group D ( P<0.05). Conclusions:Electroacupuncture preconditioning can improve cellular immune function in the patients undergoing thyroid surgery.
4.Effect of electroacupuncture preconditioning on immune function of elderly patients after radical resection for gastric cancer
Mintao ZHOU ; Caiju ZHANG ; Jinhou FU ; Jinqian HE
Chinese Journal of Anesthesiology 2020;40(8):915-918
Objective:To evaluate the effect of electroacupuncture preconditioning on the immune function of elderly patients after radical resection for gastric cancer.Methods:A total of 70 patients, aged 65 to 75 yr, with body mass index of 18-25 kg/m 2, scheduled for elective radical resection for gastric cancer, of American Society of Anesthesiology physical status Ⅱ or Ⅲ, were divided into 2 groups ( n=35 each) by a random number table method: electroacupuncture pretreatment group (group EP) and control group (group C). Combined intravenous-inhalational anesthesia was used in both groups.In group EP, electroacupuncture (continuous wave, frequency 2/100Hz, current 1 mA) of the internal anesthesia point and Zusanli acupoint was performed for 30 min before induction of anesthesia.In group C, electroacupuncture was not performed, and patient-controlled intravenous analgesia was used after operation.Before electroacupuncture and at 2, 12, 24 and 48 h after operation (T 0-4), the rating of safety and efficacy was assessed, and central venous blood samples were collected, and the percentages of CD3 + , CD4 + and CD8 + T cells were measured by flow cytometry, and the CD4 + /CD8 + ratio was calculated. Results:There was no significant difference in the rating of safety and efficacy between the two groups ( P>0.05). Compared with the baseline at T 0, the percentages of serum CD3 + and CD4 + T cells and CD4 + /CD8 + ratio at T 1-4 and percentage of CD8 + T cells at T 3 were significantly decreased in group C ( P<0.05). Compared with group C, the percentages of serum CD 3+ and CD4 + T cells and CD4 + /CD8 + ratio at T 1-4 and percentage of CD8 + T cells at T 3 were significantly increased in group EP ( P<0.05). Conclusion:Electroacupuncture of internal anesthesia points and Zusanli acupoint preconditioning can improve the immune function of elderly patients after radical resection for gastric cancer.

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