贵州医科大学学报

2018, v.43;No.216(09) 1060-1064

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电针刺激对心脏瓣膜置换术中丙泊酚及咪达唑仑用量的影响
Effect of Electroacupuncture Stimulation on Dosage of Propofol and Midazolam in Cardiac Valve Replacement

吴大庆;邹小华;章放香;黄玲;黄杰;冯典;高敏;
WU Daqing;ZOU Xiaohua;ZHANG Fangxiang;HUANG Ling;HUANG Jie;FENG Dian;GAO Min;Department of Anesthesiology,People's Hospital affiliated to Guizhou Medical University;Department of Anesthesiology,Affiliated Hospital of Guizhou Medical University;Department of Anesthesiology,Guizhou People's Hospital;

摘要(Abstract):

目的:观察电针刺激对全身麻醉体外循环(CPB)下心脏瓣膜置换术中丙泊酚及咪达唑仑用量的影响。方法:择期全麻CPB下心脏瓣膜置换术患者40例,随机分为常规全麻组(对照组)及电针刺激辅助全麻组(针刺组);针刺组于麻醉诱导前20 min于双侧合谷、曲池、足三里、阴陵泉进行电针刺激至术毕,两组术中均予中长链丙泊酚、瑞芬太尼持续泵入维持BIS值40~60;记录术中使用丙泊酚及咪达唑仑总量,于麻醉前(T1)、CPB前10 min(T2)、缝皮前10 min(T3)及转入ICU后10 min(T4)记录两组患者平均动脉压(MAP)、心率(HR)及血氧饱和度(SPO2),比较两组患者术后气管导管带管时间、ICU滞留时间以及术中知晓情况。结果:针刺组术中咪达唑仑及丙泊酚用量少于对照组,差异有统计学意义(P <0. 05);两组患者T1~T4时点的MAP、HR、SPO2相比较,差异均无统计学意义(P> 0. 05);针刺组术后气管导管带管时间和ICU滞留时间均较对照组缩短,差异有统计学意义(P <0. 05);两组均无患者知晓术中情况。结论:电针刺激辅助全身麻醉能减少体外循环下心脏瓣膜置换术中咪达唑仑及丙泊酚用量,加快术后恢复。
Objective: To observe the effect of electroacupuncture stimulation on the dosage of propofol and midazolam in cardiac valve replacement under cardiopulmonary bypass( CPB). Methods: Forty patients undergoing cardiac valve replacement under CPB were randomly divided into general anesthesia group( control group) and electroacupuncture stimulation assisted general anesthesia group( acupuncture group). Acupuncture group received electroacupuncture stimulation for 20 minutes before anesthesia induction at bilateral Hegu,Quchi,Zusanli and Yinlingquan until the end of the operation.Both groups received mid-and long-chain propofol and remifentanil sustained infusion and maintenance of BIS value of 40 ~ 60 during the operation. The total amount of propofol and midazolam was recorded during operation. The mean arterial pressure( MAP),heart rate( HR) and blood oxygen saturation( SPO2) were recorded before anesthesia( T1),10 min before CPB,10 min before suture( T3) and10 min( T4) after ICU transfer. The time of postoperative tracheobronchial intubation,ICU retention time and intraoperative knowledge were compared in the two groups. Results: The dosage of midazolam and propofol in acupuncture group was less than that in control group,and the difference was statistically significant( P < 0. 05). MAP,HR and SPO2 in the T1 ~ T4 time points of the two groups were compared,and the differences were not statistically significant( P > 0. 05). The tracheal tube length and ICU retention time in the acupuncture group were shorter than that in the control group,and the difference was statistically significant( P < 0. 05). No patients in both groups were aware of the intraoperative conditions. Conclusion: Electroacupuncture stimulation combined with general anesthesia can reduce the dosage of midazolam and propofol in cardiac valve replacement under cardiopulmonary bypass and accelerate postoperative recovery.

关键词(KeyWords): 电针;麻醉,全身;体外循环;心脏瓣膜置换术;丙泊酚;咪达唑仑
electroacupuncture;anesthesia,general;cardiopulmonary bypass;cardiac valve replacement;propofol;midazolam

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基金项目(Foundation): 贵州省科技厅基金项目[黔科合J字(2012)2060号]

作者(Author): 吴大庆;邹小华;章放香;黄玲;黄杰;冯典;高敏;
WU Daqing;ZOU Xiaohua;ZHANG Fangxiang;HUANG Ling;HUANG Jie;FENG Dian;GAO Min;Department of Anesthesiology,People's Hospital affiliated to Guizhou Medical University;Department of Anesthesiology,Affiliated Hospital of Guizhou Medical University;Department of Anesthesiology,Guizhou People's Hospital;

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