Description According to the theory of traditional Chinese medicine, bilateral Hegu (LI4), Neiguan (PC6), and Zusanli (ST36) were chosen as the acupuncture points.
Experimental Description
Sixty patients undergoing elective sinusotomy at Xijing Hospital with an ASA physical status of I–II were recruited between August 2012 and November 2012. Patients were assigned to either TEAS stimulus (TEAS group) or control group (Con group) on the basis of random numbers generated by a computer.
Sample Count
60
Age
29-60
Control
Sham
control group(n=30)
Experiment
TEAS group(n=30)
Indicator
Heart rate(HR)Mean arterial pressure(MAP)Leads I-III of the electrocardiogramEndtidal carbon dioxide pressurePeripheral oxygen saturationEpinephrine(E)Norepinephrine(NE)Adrenocorticotropic Hormone(ACTH)GlucoseCortisol(Cor)β-endorphinIntra-operative remifentanil consumptionEffects of TEAS at the time to extubationTime to recallRespiratory depressionPostoperative Nausea and Vomiting(PONV)DizzinessPruritus
Auxiliary Medication
Anaesthesia was induced i.v. with propofol and remifentanil using a target-controlled infusion (TCI) system. After loss of consciousness, vecuronium (0.1 mg kg21) was administered i.v., and patients were orotracheally intubated 5 min later. Anaesthesia was maintained with TCI of propofol and remifentanil. The surgeon did not use vasocon- strictors or local anaesthetics in the nose. In both groups, remifentanil and propofol infusions were stopped 5 min before the end of surgery. Meanwhile, prophylactic parecoxib (40 mg) and tropisetron (2 mg) were administered for postoperative pain and PONV, respectively.
Stimulation Method
TEAS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
Hwato SDZ-V
Suzhou Medical Appliances Co. Ltd, Suzhou, China
2/10 Hz
disperse-dense wave
6-9 mA
30 min
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
-
-
-
Description An experienced acupuncturist performed TEAS for 30 min before anaesthesia. According to the theory of traditional Chinese medicine, bilateral Hegu (LI4), Neiguan (PC6), and Zusanli (ST36) were chosen as the acupuncture points. These acupoints were identified according to the traditional anatomic localization (Fig. 1). Gel electrodes were applied to the skin after it had been cleaned with ethyl alcohol. The acupoints were then stimulated electrically with an intensity of 6–9 mA and dense-disperse frequency of 2/10 Hz for 30 min, using the Hwato electronic acupuncture treatment instrument (model No. SDZ-V, Suzhou Medical Appliances Co., Ltd, Suzhou, China). The intensity was adjusted to maintain a slight twitching of the local muscles according to individual maximum tolerance, indicating a satisfactory De-Qi phenomenon and thus adequate stimulation.
Anesthesia Method
GA
Clinical Trial Type
random
Effector
Patients in the TEAS group required 39% less remifentanil during surgery than controls [0.0907 (sd 0.026) μg kg−1 min−1 vs 0.051 (0.018) μg kg−1 min−1]. There were no differences in intra-operative haemodynamics or surgical stress between groups. However, the time to extubation and recall in the control group was 16.8 (6.8) min and 23.0 (5.0) min, respectively, significantly longer than that in the TEAS group (P<0.01). TEAS also decreased the incidence of dizziness and pruritus within the first 24 h after surgery (P<0.01).
"Transcutaneous electric acupoint stimulation reduces intra-operative remifentanil consumption and alleviates postoperative side-effects in patients undergoing sinusotomy: a prospective, randomized, placebo-controlled trial."
Abstract
BACKGROUND: Although opioids are widely used as analgesics in general anaesthesia, they have unpleasant side-effects and can delay postoperative recovery. Acupuncture and related techniques are effective for acute and chronic pain, and reduces some side-effects. We assessed the effect of transcutaneous electric acupoint stimulation (TEAS) on intra-operative remifentanil consumption and the incidences of anaesthesia-related side-effects. METHODS: Sixty patients undergoing sinusotomy were randomly assigned to TEAS or control group. TEAS consisted of 30 min of stimulation (6-9 mA, 2/10 Hz) on the Hegu (LI4), Neiguan (PC6), and Zusanli (ST36) before anaesthesia. The patients in the control group had the electrodes applied, but received no stimulation. Bispectral index was used to monitor the depth of anaesthesia. Perioperative haemodynamics were recorded, and peripheral blood samples were collected to measure the levels of mediators of surgical stress. The primary end point was intraoperative remifentanil consumption and the secondary endpoints were recovery quality and anaesthesia-related side-effects. RESULTS: Patients in the TEAS group required 39% less remifentanil during surgery than controls [0.0907 (SD 0.026) mug kg(-1) min(-1) vs 0.051 (0.018) mug kg(-1) min(-1)]. There were no differences in intra-operative haemodynamics or surgical stress between groups. However, the time to extubation and recall in the control group was 16.8 (6.8) min and 23.0 (5.0) min, respectively, significantly longer than that in the TEAS group (P<0.01). TEAS also decreased the incidence of dizziness and pruritus within the first 24 h after surgery (P<0.01). CONCLUSION: The use of TEAS significantly reduced intra-operative remifentanil consumption and alleviated postoperative side-effects in patients undergoing sinusotomy. CLINICAL TRIAL REGISTRATION: The trial was registered at clinicaltrials.gov (NCT01700855)."
