Description Hegu (LI4) and Waiguan (TE5), Jinmen (BL63) and Taichong (LR3), Zusanli (ST36) and Qiuxu (GB 40), and Fengchi (GB20) with Tianzhu (BL10) and Cuanzhu (BL2) with Yuyao (EX-HN4) on the craniotomy side.
Experimental Description
In a blinded clinical trial, 92 patients scheduled for supratentorial craniotomy under general anaesthesia were randomly allocated into either a multipoint TEAS (n=46) or a sham TEAS group (n=46). All patients received total intravenous anaesthesia (TIVA) with propofol and sufentanil.
Sample Count
92
Age
18-60
Control
Sham
sham TEAS group (n=46)
Experiment
multipoint TEAS group(n=46)
Indicator
Visual analog scale(VAS)Mean arterial pressure(MAP)Heart rate(HR)Bispectral index(BIS)Sufentanil target plasma concentrationsAnesthetic dosageTime to spontaneous respirationExtubation timeEye-opening timeTime to spontaneous movementTime to reorientationTime to discharge from the operating roomIncidence of respiratory depressionPostoperative Nausea and Vomiting(PONV)
Auxiliary Medication
Anaesthesia was induced by intravenous infusion of propofol (1% Diprivan) and sufentanil (0.2 mg/mL) to maintain their target plasma concentrations at 5 μg/mL and 0.5 ng/mL, respectively. Sufentanil was administered as target-controlled infusion using the pharmacokinetic model of Bovill et al. After loss of consciousness, target plasma concentrations of propofol and sufentanil were each subsequently reduced to 3.2 μg/mL and 0.3 ng/mL. Vecuronium bromide 0.1 mg/kg was given intravenously to facilitate tracheal intubation and muscle relaxation. Mechanical ventila- tion with a 40% oxygen/air mixture was applied with the tidal volume of 10 mL/kg, respiratory frequency of 12 times/min and gas flow of 1 L/min set. The dose of propofol was stable during the operation for anaesthetic maintenance and sufentanil concentration was adjusted to maintain the mean arterial pressure (MAP), HR and BIS in the basic range of +10% to -20%. Vecuronium bromide of 0.05 mg/kg was injected intravenously and intermittently to retain muscle relaxation (T4/T1<25%) according to the results of muscle relaxation (train of four stimulation). Local infiltration anaesthesia of the incision was obtained by 0.5% ropivacaine. After the operation, analgesic compound liquid, consisting of 50 mL of normal saline and 100 μg of sufentanil, 1 mL/h was given through a sustaining pump with a single injecting volume of 0.5 mL and locking time of 10 min.
Stimulation Method
TEAS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
HANS LH-202
Beijing Huawei Co, Ltd., Beijing, China
2/100 Hz
disperse-dense wave
The intensity of stimulation was set at 4.89±2.15, 6.79±3.51, 7.04±3.35 and 5.61±2.13, respectively, according to the maximal tolerance of patients and maintained throughout the operation.
tarting 30 min before anaesthesia induction, maintained throughout the operation and terminated at the end of surgery (removal of headstock).
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
-
-
-
Description TEAS was performed using a Han’s acupoint nerve stimulator (LH202H, Beijing Huawei Co, Ltd, Beijing, China) with a dense-disperse frequency of 2/100 Hz (alternated once every 3 s; 0.6 ms at 2 Hz and 0.2 ms at 100 Hz). The intensity of stimulation was set at 4.89±2.15, 6.79±3.51, 7.04±3.35 and 5.61±2.13, respectively, according to the maximal tolerance of patients and maintained throughout the operation.
Anesthesia Method
AAA
Clinical Trial Type
a blinded, randomly clinical trial
Effector
Eighty-eight patients completed the study. Continuous monitoring of MAP, HR and BIS showed stable values with no significant differences between the two groups (p>0.05). Sufentanil target plasma concentration in TEAS patients was significantly lower at some time points during supratentorial craniotomy, and total sufentanil consumption was significantly higher in the sham group (p<0.05). Postoperative recovery and pain were significantly improved by TEAS (p<0.001), without the postoperative side effects. Multipoint TEAS at both proximal and distal points combined with TIVA can significantly decrease intraoperative sufentanil requirements, increase pain relief on postoperative day 1 and improve postoperative recovery of patients during supratentorial tumour resection, with no significant increase of side effects. These findings suggest that multipoint TEAS may be clinically effective as an adjunct to analgesia in intraoperative anaesthesia and postoperative pain treatment and may speed recovery.
Intraoperative and postoperative anaesthetic and analgesic effect of multipoint transcutaneous electrical acupuncture stimulation combined with sufentanil anaesthesia in patients undergoing supratentorial craniotomy.
Abstract
OBJECTIVES: To investigate the anaesthetic and analgesic effect of multipoint transcutaneous electrical acupuncture stimulation (TEAS) during supratentorial tumour resection for postoperative recovery and side effects. METHODS: In a blinded clinical trial, 92 patients scheduled for supratentorial craniotomy under general anaesthesia were randomly allocated into either a multipoint TEAS (n=46) or a sham TEAS group (n=46). All patients received total intravenous anaesthesia (TIVA) with propofol and sufentanil. The target concentration of sufentanil was adjusted and recorded according to mean arterial pressure (MAP), heart rate (HR) and bispectral index (BIS). Patients in the TEAS group received TEAS 30 min before anaesthesia induction and this was maintained throughout the operation at four pairs of acupuncture points. Postoperative pain, recovery and side effects were evaluated. RESULTS: Eighty-eight patients completed the study. Continuous monitoring of MAP, HR and BIS showed stable values with no significant differences between the two groups (p>0.05). Sufentanil target plasma concentration in TEAS patients was significantly lower at some time points during supratentorial craniotomy, and total sufentanil consumption was significantly higher in the sham group (p<0.05). Postoperative recovery and pain were significantly improved by TEAS (p<0.001), without the postoperative side effects. CONCLUSIONS: Multipoint TEAS at both proximal and distal points combined with TIVA can significantly decrease intraoperative sufentanil requirements, increase pain relief on postoperative day 1 and improve postoperative recovery of patients during supratentorial tumour resection, with no significant increase of side effects. These findings suggest that multipoint TEAS may be clinically effective as an adjunct to analgesia in intraoperative anaesthesia and postoperative pain treatment and may speed recovery. TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry (registration number ChiCTR-TRC-10001078)."
