Qi Sheng, Wu Xin-Qin, Lu Xiao-Bo
Zhongguo Zhen Jiu. 2014 May;34(5):483-6.
To explore the effectiveness and safety of transcutaneous electrical acupoint stimulation (TEAS) combined with infusion of propofol in anodynia bronchoscopy.
Ninety patients who received selective bronchoscopy were randomized into a group of compound TEAS with infusion of propofol (group A), a group of compound fentanyl with propofol (group B) and a group of simple propofol (group C). In group A, the plaster electrode stimulation was applied at bilateral Hegu (LI 4), Laogong (PC 8), Neiguan (PC 6) and Waiguan (TE 5). The anesthesia was induced after 20 min of stimulation till the end of examination. In group B and group C, the electric stimulation was not adopted. In group B, before anesthesia, fentanyl 1 microg/kg was injected intravenously. Afterwards, the intravenous infusion of propofol was used in the the three groups for anesthesia. The mean arterial pressure (MAP), heart rate (HR), saturation of pulse oximetry (SpO2) and respiratory rate (RR) were recorded at different time points. The induced dosage and total dosage of propofol, examination time, the awakening time and adverse reactions were observed in the patients of each group.
The difference in examination time was not significant among the three groups (P > 0.05). The postoperative awakening time in group A was earlier than that in group B and group C [(220.3 +/- 110.5) s vs (285.6 +/- 109.4) s, (290.1 +/- 105.1) s, both P < 0.05]. The total dosage of propofol in group C was larger than those in group A and group B [(288.5 +/- 26.7) mg vs (225.1 +/- 30.2) mg, (230.4 +/- 29.3) mg, both P < 0.05]. The induced dosage in group C was larger than those in group A and group B [(193.7 +/- 42.3) mg vs (152.3 +/- 36.1) mg, (155.4 +/- 40.5) mg, both P < 0.05]. Every life physical sign in group A during examination was more stable as compared with that in group B and group C. The incidence of hypotension and bradycardia in group A were lower than those in group C [3.3% (1/30) vs 26.7% (8/30), 0% (0/30) vs 20.0% (6/30), both P < 0.05]. The adverse incidence of oxygen supply in group A was lower than that in group B [6.7% (2/30) vs 33.3% (10/30), P < 0.05]. Intraoperative awareness and improper memory did not happen in postoperative investigation.
In the transcutaneous electrical acupoint stimulation combined with infusion of propofol in anodynia bronchoscopy, the physical sign of patient is stable with less adverse reactions. This method reduces anesthetic dosage and shortens the postoperative awakening time, which can be effectively applied in bronchoscopy.
探讨经皮穴位电刺激(TEAS)联合丙泊酚输注用于无痛支气管镜检查的有效性及安全性。
将90例行选择性支气管镜检查的患者随机分为经皮穴位电刺激联合丙泊酚输注组(A组)、芬太尼复合丙泊酚组(B组)和单纯丙泊酚组(C组)。A组采用膏药电极刺激双侧合谷(LI 4)、劳宫(PC 8)、内关(PC 6)和外关(TE 5),刺激20分钟后诱导麻醉直至检查结束。B组和C组不采用电刺激。B组在麻醉前静脉注射芬太尼1μg/kg。之后,三组均采用丙泊酚静脉输注进行麻醉。记录不同时间点的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)和呼吸频率(RR)。观察每组患者丙泊酚的诱导剂量和总剂量、检查时间、苏醒时间及不良反应。
三组检查时间差异无统计学意义(P>0.05)。A组术后苏醒时间早于B组和C组[(220.3±110.5)秒 vs (285.6±109.4)秒,(290.1±105.1)秒,P均<0.05]。C组丙泊酚总剂量大于A组和B组[(288.5±26.7)毫克 vs (225.1±30.2)毫克,(230.4±29.3)毫克,P均<0.05]。C组丙泊酚诱导剂量大于A组和B组[(193.7±42.3)毫克 vs (152.3±36.1)毫克,(155.4±40.5)毫克,P均<0.05]。A组检查过程中各项生命体征较B组和C组更稳定。A组低血压和心动过缓发生率低于C组[3.3%(1/30) vs 26.7%(8/30),0%(0/30) vs 20.0%(6/30),P均<0.05]。A组氧供不良反应发生率低于B组[6.7%(2/30) vs 33.3%(10/30),P<0.05]。术后调查未发生术中知晓和记忆错误。
经皮穴位电刺激联合丙泊酚输注用于无痛支气管镜检查时,患者体征稳定,不良反应少。该方法减少了麻醉药物用量,缩短了术后苏醒时间,可有效应用于支气管镜检查。