Description Acupoints Zusanli (ST 36), Neiguan (PC 6), Hegu (LI 4), and Shangjuxu (ST 37) were positioned on both sides
Experimental Description
We recruited 96 elderly patients who received anesthesia for subtotal gastrectomy and randomly divided them into control (n=48) and experimental (n=48) groups. The control group received general anesthesia and the experimental group received combined acupuncture and general anesthesia.
Sample Count
96
Age
60-85
Control
Std
control(n=48)
Experiment
experimental(n=48)
Indicator
CD3CD4CD8Heart rate(HR)Mean arterial pressure(MAP)SpO2Partial pressure of end-tidal carbon dioxide(PETCO2)Postoperative Nausea and Vomiting(PONV)Montreal cognitive assessment(MoCA)Mini-mental state examination(MMSE)Side effectsHypoxemiaDelayed recoveryPostoperative agitation
Auxiliary Medication
0.1 g phenobarbital sodium (Tianjin Kingyork Group, approval no. NMPN H12020381) and 0.5 mg atropine (Jiangsu Lianshui Pharmaceutical, approval no. NMPN H32020166) were injected intramuscularly 30 min before the anesthesia, and arterial blood gas and blood pressure were monitored.
Only general anesthesia was used in the control group. After mask oxygen inhalation, midazolam (Yichang Humanwell Pharmaceutical, approval no. NMPN H20067040) at a dose of 0.05 mg/kg, fentanyl (Yichang Humanwell Pharmaceutical, approval no. NMPN H42022076) at a dose of 4 µg/kg, vecuronium bromide (Jiangsu Nhwa Pharmaceutical, approval no. NMPN H20113296) at a dose of 0.12 mg/kg, and propofol (Xi'an Libang Pharmaceutical, approval no. NMPN H20010368) at a dose of 2.5 mg/kg were injected intravenously. Trachea intubation was executed after the muscles were relaxed, and then it was connected to an all-round anesthetic machine (Drager, Lübeck, Germany) for intermittent positive pressure ventilation: tidal volume, 8–10 m/kg; respiratory rate, 12 breaths/min: partial pressure of end-tidal carbon dioxide (PETCO2), 30–40 mmHg. Intermittent bolus injection of 2 µg/kg/h fentanyl and 4 mg/kg/h propofol were performed and 0.1 mg/kg/h vecuronium bromide was pumped into vein to maintain the anesthesia.
Stimulation Method
EA
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
-
-
80-90 times/min
-
the level that was bearable to the patients
15-20 min
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
-
-
-
Description After needling sensation was achieved, the filiform needles were connected with the electronesthesia apparatus at 80–90 times/min frequency. Then, the intensity was gradually increased to the level that was bearable to the patients and the stimulation time was 15–20 min.
Anesthesia Method
AAA
Clinical Trial Type
randomly
Adverse Effects
The analysis of adverse reactions after operation showed no obvious differences in nausea and vomiting, hypoxemia, and delayed recovery between the two groups. However, the incidence of postoperative agitation was significantly decreased in the experimental group (0 cases) compared with that in the control group (7 cases) (Table VIII).
Effector
We found no significant differences in mean heart rate (HR), mean oxygen saturation (SpO2), and partial pressure of end-tidal carbon dioxide (PETCO2) in the perioperative period between the two groups. Mean arterial pressure (MAP) was lower in the experimental group than that in the control group (P<0.05). The levels of cluster of differentiation 3 (CD3+), CD4+ and CD4+/CD8+ in both groups were significantly lower after surgery in both groups (P<0.05). We also found some time-points in which the immune markers where significantly higher in the experimental group. In terms of adverse reactions, there were no differences in nausea, vomiting, and hypoxemia between the two groups (P>0.05), but the incidence of delayed recovery and postoperative agitation were significantly lower in the experimental group compared with those in the control group (P<0.05). One day after surgery, the experimental group showed better protection of cognitive function than the control group (P<0.05). Overall, combined acupuncture and general anesthesia in elderly gastric cancer patients receiving subtotal gastrectomy showed more stable hemodynamics and fewer stress responses during surgery.
Combined acupuncture and general anesthesia on immune and cognitive function in elderly patients following subtotal gastrectomy for gastric cancer.
Abstract
This study investigated the effects of acupuncture combined with general anesthesia on postoperative immune and cognitive functions in elderly patients undergoing subtotal gastrectomy. We recruited 96 elderly patients who received anesthesia for subtotal gastrectomy and randomly divided them into control (n=48) and experimental (n=48) groups. The control group received general anesthesia and the experimental group received combined acupuncture and general anesthesia. We measured hemodynamic immediately before and after anesthesia induction, and immune observations before and after surgery. We found no significant differences in mean heart rate (HR), mean oxygen saturation (SpO2), and partial pressure of end-tidal carbon dioxide (PETCO2) in the perioperative period between the two groups. Mean arterial pressure (MAP) was lower in the experimental group than that in the control group (P<0.05). The levels of cluster of differentiation 3 (CD3(+)), CD4(+) and CD4(+)/CD8(+) in both groups were significantly lower after surgery in both groups (P<0.05). We also found some time-points in which the immune markers where significantly higher in the experimental group. In terms of adverse reactions, there were no differences in nausea, vomiting, and hypoxemia between the two groups (P>0.05), but the incidence of delayed recovery and postoperative agitation were significantly lower in the experimental group compared with those in the control group (P<0.05). One day after surgery, the experimental group showed better protection of cognitive function than the control group (P<0.05). Overall, combined acupuncture and general anesthesia in elderly gastric cancer patients receiving subtotal gastrectomy showed more stable hemodynamics and fewer stress responses during surgery. Thus, combined acupuncture and general anesthesia can shorten the recovery time from anesthesia, have less negative effects on immune function and decrease the incidence of postoperative cognitive impairment."
Souce
Oncol Lett. 2018 Jan;15(1):189-194. doi: 10.3892/ol.2017.7262. Epub 2017 Oct 24.
