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北京大学人民医院麻醉科
纸质出版日期:2019
移动端阅览
梁汉生, 李奕楠, 冯艺. 经皮穴位电刺激的麻醉前预保温作用观察[J]. 针刺研究, 2019,44(10):747-751.
LIANG Han-sheng, LI Yi-nan, FENG Yi. Prewarming effect of transcutaneous acupoint electrical stimulation preconditioning in patients undergoing elective video-assisted thoracoscopic lobectomy[J]. Acupuncture research, 2019, 44(10): 747-751.
梁汉生, 李奕楠, 冯艺. 经皮穴位电刺激的麻醉前预保温作用观察[J]. 针刺研究, 2019,44(10):747-751. DOI: 10.13702/j.1000-0607.190472.
LIANG Han-sheng, LI Yi-nan, FENG Yi. Prewarming effect of transcutaneous acupoint electrical stimulation preconditioning in patients undergoing elective video-assisted thoracoscopic lobectomy[J]. Acupuncture research, 2019, 44(10): 747-751. DOI: 10.13702/j.1000-0607.190472.
目的:观察经皮穴位电刺激的麻醉前预保温作用。方法:80例择期行胸腔镜肺叶切除手术患者随机分为穴位组和对照组
每组40例。入麻醉准备间后
穴位组选取大椎和命门进行经皮穴位电刺激
30 min后停止刺激
转入术间开始麻醉;对照组只贴电极
不刺激。两组患者均采用全凭静脉麻醉
用双频谱指数控制麻醉深度。观察并记录入麻醉准备间前后、入手术间以及术中各时点的体温变化
同时记录两组患者的低体温发生率、血压、心率、麻醉时间、手术时间、出血量、尿量、输液量、苏醒时间、苏醒期寒战等指标。结果:两组患者低体温发生率、血压、心率、麻醉时间、手术时间、出血量、尿量、总输液量的差异均无统计学意义(P>0. 05)。出准备间和入手术间时
穴位组患者体温明显高于对照组(P<0. 05)。穴位组患者苏醒时间明显短于对照组(P<0. 05)。穴位组患者苏醒期寒战发生率(3/40
7. 5%)较对照组(7/40
17. 5%)明显降低(P<0. 05)。结论:术前经皮电刺激大椎和命门有麻醉前预保温作用
可延缓术中体温下降的速度
能缩短苏醒时间
降低苏醒期寒战的发生率
但不能降低胸腔镜肺叶切除术患者术中低体温发生率。
Objective To observe the prewarming effect of transcutaneous acupoint electrical stimulation(TAES)preconditioning of Dazhui(GV14)and Mingmen(GV4)in patients undergoing elective video-assisted thoracoscopic lobectomy
so as to determine whether TAES can improve intraoperative hypothermia.Methods A total of 80 patients undergoing elective video-assisted thoracoscopic lobectomy were randomly divided into TAES group(40 cases)and control group(40 cases). Before surgery
all the patients were transferred to the fixed area of an anesthetic preparation room by using a surgery cart carrying the same temperature sheets and quilts before surgery. TAES(2 Hz/100 Hz
20—30 m A)was applied to Dazhui(GV14)and Mingmen(GV4)for 30 min for patients of the TAES group and the same sheet electrodes of EA stimulator were only attached to GV14 and GV 4 without electrical current transmission for patients in the control group. Then
these patients in the two groups were transferred to the operation room and treated by total intravenous anesthesia
and their anesthetic depth was monitored with bispectral index(BIS
between 45—60)and endtidal carbon dioxide tension(PETCO2
between 30—45 mm Hg). The auricular tympanic temperature was monitored
and when the temperature was below 35. 5 ℃
forced-air blanket was used to warm the patient as the remedial measure. The same temperature of operation room
surgical drape
infusion solution and pleural lavage fluid were controlled. The patients' body temperature in the preparation room and operation room during surgery
incidence of hypothemia
blood pressure(BP)
heart rate(HR)
duration of anesthesia
duration of operation
blood loss volume
urine output
total infusion volume
recovery(awaking)time
and chills during recovery were recorded.Results The body temperature of patients in the TAES group was significantly higher than that in the control group at the time of entering the operation room(P<0. 05). The incidence of chills during recovery was obviously lower in the TAES group(3/40
7. 5%)than in the control group(7/40
17. 5%
P<0. 05)
and the recovery time was significantly shorter in the TAES group than in the control group(P<0. 05). There were no significant differences between the two groups in the incidence of intraoperative hypothermia
the duration of anesthesia and operation
blood loss volume
urine output
total infusion volume
BP and HR(P>0. 05).Conclusion TAES preconditioning of GV14 and GV4 can produce prewarming effect before anesthesia
shorten the awaking time and reduce the incidence of chills in the recovery period in patients undergoing elective video-assisted thoracoscopic lobectomy.
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