Objective To observe the effectiveness of transcutaneous acupoint electrical stimulation(TAES)or electroacupuncture(EA)stimulation of different acupoints in combination with anesthetics in the management of thyroidectomy patients

so as to choose a better stimulating method and most effective acupoints for thyroidectomy.Methods A total of 216 thyroidectomy patients(ASA Ⅰ-Ⅱ grades)with thyroid gland adenoma

thyroid cyst or thyroid nodules from 3hospitals(3research centers)were randomized into 6groups

i.e.

local anesthesia(LA

n=34)

Futu(LI 18)-EA(n=36)

Hegu(LI 4)-Neiguan(PC 6)-TAES(n=34)

LI 4-PC 6-EA(n=36)

Yanglingquan(GB 34)-EA(n=36)and non-acupoint(NA

about 1.5cm latero-posterior to KI 9)-EA(n=34)groups according to the hospitalizition sequence.For patients of the LI 18-EA

LI 4-PC 6-TAES/EA

GB 34 and non-acupoint-EA groups

EA or TAES(2Hz/100Hz)was applied to the abovementioned bilateral acupoints or non-acupoint till the termination of the surgical operation.The surgery was conducted under anesthesia by local injection of0.5%lidocaine and midazolam

and intravenous injection of fentanyl(for severe pain cases)20min after beginning of TAES or EA.The patients' scores of visual analogue scale(VAS)

mean arterial pressure(MAP)and heart rate(HR)at the time-points of pre-anesthesia(T 0)

skin-incision(T 1)

skin flap-freeing(T 2)

anterior cervical muscle traction(T 3)

thyroid upper/lowerpole-sectioning(T 4/T 5)

and thyroidectomy(T 6)

and the dosages of the administered fentanyl and lidocaine were recorded.Results Compared with the corresponding time-points of the non-acupoint group

the VAS scores at T 1and T 4time-points in the LI 18-EA group and LI 4-PC 6-EA group

at T 1

T 5and T 6time-points in the LI 4-PC 6-TAES group were significantly lower(P<0.05).Compared with the corresponding time-points of the LA group

the VAS scores at T 2

T 3

T 5and T 6time-points in the LI 18-EA group and LI 4-PC 6-EA group

at T 3

T 5and T 6in the LI 4-PC 6-TAES group

and the MAP levels at T 2

T 3

T 4and T 6time-points in the LI 18-EA group

at T 3

T 4in the LI 4-PC 6-EA group

at T 3

T 4

T 6in the LI 4-PC 6TAES group

as well as the HR levels at T 4

T 5and T 6in the LI 18-EA group

and at T 5

T 6in the LI 4-PC 6-TAES group were significantly lower(P<0.05).The dosages of fentanyl in the LI 18-EA and LI 4-PC 6-TAES groups

and those of lidocaine in the LI 18-EA

LI 4-PC 6-EA and TAES groups were significantly lower relevant to the LA group and non-acupoint group(P<0.05).No significant differences were found between the LA and GB 34-EA groups

and between the LA and non-acupoint groups

as well as between the LI 4-PC 6-EA and LI 4-PC 6-TAES groups in the VAS scores

the MAP and HR levels

the dosages of lidocaine and fentanyl consumption(P>0.05).Conclusion EA stimulation of both LI 18 and LI 4-PC 6and TAES of LI 4-PC 6combined with anesthetics have a better effect in inducing analgesia and controlling MAP and HR

and need lower dosages of anesthetics for patients undergoing thyroidectomy

for which LI 18 and LI 4-PC 6are evidently superior to GB 34 and non-acupoint.Hence

combined EA or TAES and anesthetics is highly recommended for thyroidectomy