Description Neiguan, Hegu, Lieque, and Quchi on the sick lateral
Experimental Description
Eighty VATS lobectomy patients with no previous experience of TEAS or acupuncture were randomly assigned to four groups: control (con), 2/100, 2, and 100 Hz. The last three experimental groups received TEAS at the indicated frequencies for 30 min before induction, during the operation, and for another 30 min 24 and 48 h after surgery. 2/100 Hz is a type of alternating frequency which goes between 2 and 100 Hz every 3 s. TEAS was administered over acupoints Neiguan, Hegu, Lieque, and Quchi on the sick lateral. Electrodes were applied to the patients in the control group, but no TEAS was used.
Sample Count
80
Control
Freq
Placebo
control (con)(n=20)
Experiment
2/100 Hz(n=20); 2Hz(n=20);100 Hz(n=20)
Indicator
Anesthetic dosageBlood gas analysis resultsLung function indexes FEV1 and FVCPost-anesthesia care unit(PACU) statuspostoperative complicationsQuality of life scores
Auxiliary Medication
After 30 min of TEAS or placebo-TEAS, intravenous induction was started with 1.5-2 mg/ kg propofol, 0.2-0.4 μg/kg sufentanil, and 0.2 mg/kg cisatracurium. Anesthesia was maintained by continuous infusion of cisatracurium (0.06 mg kg-1 h-1) and target controlled infusion (TCI) of propofol and remifentanil. The bi-spectrum index was maintained within the range 40-60 by adjusting the propofol concentration, and ANI was maintained within the range 50-70 by adjusting the remifentanil concentration, according to the Marsh and Minto models, respectively. If the remifentanil target controlled infusion concentration reached 6 ng/mL but the ANI was still below 50, sufentanil (0.1 μg/kg) was administered. Sufentanil (0.1 μg/kg), urbiprofen (100 mg), and tropisetron (5 mg) were administered 30 min before the end of surgery for analgesia transition and prevention of postoperative nausea and vomiting (PONV). A patient-controlled intravenous analgesia pump was connected (1 μg/mL sufentanil and 1.2 mg/mL urbiprofen; ow rate, 2 mL/h; bolus, 3 mL; lockout time, 15 min). On skin closure, administration of all anesthetics was stopped, and the surgeon administered intercostal nerve block with 0.5 % ropivacaine, 10 ml, after which the patient was transferred to the post-anesthesia care unit (PACU). After spontaneous breath recovery, the patient was given muscle relaxant reversal, neostigmine 2 mg, and atropine 1 mg, extubated when the required criteria were achieved, and discharged from the PACU after the modi ed Aldrete discharge criteria were achieved.
Stimulation Method
TEAS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
HANS-200A
-
2/100 Hz;2 Hz; 100 Hz
disperse-dense wave
at the highest tolerable level that caused no discomfort to the participant.
30 min(before induction, 24 and 48 h after surgery), during the entire intraoperative period.
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
-
-
-
Description We used HANS-200A Acupoint Stimulator for TEAS. The intensity was set at the highest tolerable level that caused no discomfort to the participant. The frequency was set as 2/100, 2, or 100 Hz for the experimental groups. 2/100 Hz stimuli were in the dense-and-disperse mode, in which 2 and 100 Hz are alternated every 3 s. All participants received 30 min of TEAS or placebo-TEAS before induction, during the entire intraoperative period, and 30 min of TEAS or placebo-TEAS 24 and 48 h after surgery.
Anesthesia Method
AAA
Clinical Trial Type
A randomized, placebo-controlled, double-blinded study
Contraindications
Neural damage or infection along the meridian on which the acupoints lay
Effector
Intraoperative opioid consumption was lowest in the 2/100 Hz group, with statistical signi cance (con, P ≤ 0.001; 2 Hz, P ≤ 0.001; 100 Hz, P = 0.026). Compared with preoperative FEV1 and FVC, postoperative FEV1 and FVC were signi cantly lower in all groups; during one-lung ventilation, arterial oxygen partial pressure (PaO2) decreased more slowly in the 2/100 Hz group than in the con group (P = 0.042). Moreover, in the 2/100 Hz group extubation time was shorter (P = 0.038), visual analgesia scale score lower (P = 0.047), and duration of PACU stay shorter (P = 0.043) than in the con group. In the 100 Hz group incidence of postoperative nausea and vomiting (PONV) was lower than the con group (P = 0.044). In all groups mean postoperative physical component scores were signi cantly lower than mean preoperative scores. TEAS is a safe noninvasive adjunctive intervention for anesthesia management among patients undergoing VATS lobectomy. TEAS at 2/100 Hz can reduce intraoperative opioid dosage and slow the decrease of PaO2 during one-lung ventilation. It can also effectively reduce pain score, extubation time, and PACU stay immediately after surgery. Further, 100 Hz TEAS can reduce PONV morbidity.
"Effects of transcutaneous electrical acupoint stimulation at different frequencies on perioperative anesthetic dosage, recovery, complications, and prognosis in video-assisted thoracic surgical lobectomy: a randomized, double-blinded, placebo-controlled trial."
Abstract
BACKGROUND: Transcutaneous electrical acupoint stimulation (TEAS), a non-invasive and non-pharmacological adjunctive intervention for perioperative analgesia, may also reduce the incidence of postoperative pulmonary complications. The effect of TEAS on video-assisted thoracic surgical (VATS) patients is still unknown, however. The purpose of this study was to investigate the effects of TEAS of different frequency on perioperative anesthetic dosage, recovery, complications, and prognosis for patients undergoing VATS lobectomy. METHODS: Eighty VATS lobectomy patients with no previous experience of TEAS or acupuncture were randomly assigned to four groups: control (con), 2/100, 2, and 100 Hz. The last three experimental groups received TEAS at the indicated frequencies for 30 min before induction, during the operation, and for another 30 min 24 and 48 h after surgery. 2/100 Hz is a type of alternating frequency which goes between 2 and 100 Hz every 3 s. TEAS was administered over acupoints Neiguan, Hegu, Lieque, and Quchi on the sick lateral. Electrodes were applied to the patients in the control group, but no TEAS was used. Anesthetic dosage, blood gas analysis results, lung function indexes FEV(1) and FVC, post-anesthesia care unit (PACU) status, postoperative complications, and quality of life scores were recorded and analyzed statistically. RESULTS: Intraoperative opioid consumption was lowest in the 2/100 Hz group, with statistical significance (con, P
