围术期电针刺激对七氟醚全麻患者术后嗅觉记忆的影响Effect of Perioperative Electroacupuncture on Postoperative Olfactory Memory in Patients with General Anesthesia of Sevoflurane
黄健,高鸿,周菁,任益民,席特,高华琳,王安琦,周微,曹莹
HUANG Jian,GAO Hong,ZHOU Jing,REN Yimin,XI Te,GAO Hualin,WANG Anqi,ZHOU Wei,CAO Ying
摘要(Abstract):
目的:观察围术期电针刺激迎香穴和印堂穴对七氟醚全麻患者术后嗅觉记忆的影响。方法:择期在全身麻醉下行妇科、泌尿科等手术的成年患者40例,随机均分为电针干预组(E组)和七氟醚组(S组),电针干预组选取迎香穴(双侧)和印堂穴于麻醉诱导前10 min进行电针刺激然后行全身麻醉、电针刺激至手术结束,七氟醚组不予电针处理、麻醉方法与电针干预组相同;记录2组患者麻醉诱导前(T_0)、手术开始后30 min(T_1)和手术结束时(T_2)的平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SpO_2)及术中七氟醚用量;于麻醉诱导前(T_0)和手术后当Aldrete评分达10分时(T_3),采用康涅狄格化学感觉临床研究中心(CCCRC)嗅觉检查法进行嗅觉识别检测,比较2组患者嗅觉识别得分。结果:与干预组比较,七氟醚组T_0时点嗅觉识别分值比较差异无统计学意义(P>0.05),七氟醚组T_3时点嗅觉识别分值降低,差异有统计学意义(P<0.05);与七氟醚组比较,七氟醚组T_3时点嗅觉识别分值降低,差异有统计学意义(P<0.05),2组患者性别构成、年龄、BMI等一般情况和术中情况差异无统计学意义(P>0.05)。结论:电针刺激迎香穴和印堂穴可提高七氟醚全麻患者术后嗅觉记忆得分,改善全麻手术患者术后嗅觉记忆障碍。
Objective: To observe the effect of perioperative electroacupuncture Yingxiang and Yintang acupoints on postoperative olfactory memory in patients with General Anesthesia of Sevoflurane. Methods: Forty adult patients with gynecological and urological procedures with general anesthesia, aged 18~60 years, were randomly divided into the electroacupuncture intervention group(group E) and the sevoflurane group(group S), 20 cases in each group. In group E: Electroacupuncture was administered to patients at Yingxiang(two sides)(LI 20) and Yintang(GV 29) acupoints from 10 minutes before anesthesia to the end of operation; then general anesthesia was performed. In group S, patients did not not receive electroacupuncture stimulation, the method of anesthesia was the same as that of group E. The mean arterial pressure(MAP), heart rate(HR) and oxygen saturation(SpO_2) were recorded before induction of anesthesia(T_0), 30 min after surgery(T_1) and at the end of surgery(T_2). The dosage of sevoflurane during operation was calculated. Olfactory memory was tested using the olfactory test of Connecticut Chemosensory Clinical Research Center(CCCRC); the scores were recorded before induction of anesthesia(T_0) as the Aldrete Recovery Score reached 10(T_3) in the postoperative period. Results: Compared with group E, there was no significant difference of the olfactory recognition scores of group S in T_0;the olfactory recognition scores of group S in T_3 decreased(P<0.05). Compared with group S, the olfactory recognition scores of group S in T_3 decreased(P<0.05). There was no statistically difference of baseline characteristics between both groups(such as gender composition, age and BMI) during the operation. Conclusion: Electroacupuncture Yingxiang and Yintang acupoints can improve the olfactory memory scores of patients with general anesthesia of sevoflurane and improve the occurrence of the olfactory memory disorder after general anesthesia.
关键词(KeyWords):
围术期;电针;穴位;七氟醚;嗅觉记忆
perioperative;electroacupuncture;acupoint;sevoflurane;olfactory memory
基金项目(Foundation): 贵州省中医药管理局基金资助(QZYY2017-032);; 贵州省卫生计生委科学技术基金(gzwjkj2016-1-007)
作者(Author):
黄健,高鸿,周菁,任益民,席特,高华琳,王安琦,周微,曹莹
HUANG Jian,GAO Hong,ZHOU Jing,REN Yimin,XI Te,GAO Hualin,WANG Anqi,ZHOU Wei,CAO Ying
DOI: 10.19367/j.cnki.1000-2707.2019.12.019
参考文献(References):
- [1] DAHMANI L,PATEL R M,YANG Y,et al.An intrinsic association between olfactory identification and spatial memory in humans[J].Nat Commun,2018,9(1):4162.
- [2] DEVANAND D P.Olfactory identification deficits,cognitive decline,and dementia in older adults[J].Am J Geriatr Psychiatry,2016,24(12):1151-1157.
- [3] SARAVANAN B,KUNDRA P,MISHR A,et al.Effect of anaesthetic agents on olfactory threshold and identification-A single blinded randomised controlled study[J].Indian J Anaesth,2018,62(8):592-598.
- [4] 郭波,谢亮,邓田,等.电针对老年全麻手术患者术后早期认知功能障碍的影响[J].中国中医急症,2017,26(6):1083-1086.
- [5] VEYSELLER B,KARAALTIN A B.Connecticut (CCCRC) olfactory test:Normative values in 426 healthy volunteers[J].Indian J Otolaryngol Head Neck Surg,2014,66(1):31-34.
- [6] 耿桂启,刘海恋,黄绍强.一种计算手术中七氟烷消耗量的简便方法[J].复旦学报(医学版),2014,41(6):819-822.
- [7] SHARMA A,KUMAR R,AIER I,et al.Sense of smell:Structural,functional,mechanistic advancements and challenges in human olfactory research[J].Current Neuropharmacology,2019,17:1-21.
- [8] BRUNJES P C,ILLIG K R,MEYER E A.A field guide to the anterior olfactory nucleus (cortex)[J].Brain Res Brain Res Rev,2005,50(2):305-335.
- [9] ROMBAUX P,DUPREZ T,HUMMEL T.Olfactory bulb volume in the clinical assessment of olfactory dysfunction[J].Rhinology,2009,47(1):3-9.
- [10]L?TSCH J,REICHMANN H,HUMMEL T.Different odor tests contribute differently to the evaluation of olfactory loss[J].Chem Senses,2008,33(1):17-21.
- [11]KOSTOPANAGIOTOU G,KALIMERIS K,KESIDIS K,et al.Sevoflurane impairs post-operative olfactory memory but preserves olfactory function[J].Eur J Anaesthesiol,2011,28(1):63-68.
- [12]修欢欢,邝立挺,林世清,等.七氟醚对果蝇蛹认知功能的影响[J].实用医学杂志,2014,30(19):3052-3054.
- [13]BILGI M,DEMIRHAN A,AKKAYA A,et al.Effects of isoflurane on postoperative olfactory memory[J].Acta Medica Mediterranea,2014,30(2):453-456.
- [14]DEMIRHAN A,ERDEM K,AKKAYA A,et al.Evaluation of the olfactory memory after spinal anesthesia:a pilot study[J].Eur Rev Med Pharmacol Sci,2013,17(18):2428-2432.
- [15]LECKER I,YIN Y,WANG D S,et al.Potentiation of GABAA receptor activity by volatile anaesthetics is reduced by (5GABAA receptor-preferring inverse agonists[J].Br J Anaesth,2013,110(1):73-81.
- [16]王强,刘智斌,王渊,等.“嗅三针”干预对帕金森病模型小鼠嗅球超微结构及胶质纤维酸性蛋白表达的影响[J].中国针灸,2018,38(10):1093-1098.
- [17]KIM H,KIM H Y,KIM Y S,et al.Cognitive improvement effects of electroacupuncture for the treatment of MCI compared with western medications:a systematic review and meta-analysis[J].BMC Complementary and Alternative Medicine,2019,19(13):1-15.
- [18]杨欢,郑小兰,徐国海.电针刺激对糖尿病患者术后认知功能及血清炎性因子的影响[J].临床麻醉学,2015,31(11):1073-1076.
- [19]刘智斌,牛文民,杨晓航,等.嗅三针治疗血管性痴呆的随机对照研究[J].针刺研究,2008,33(22):131-133.
文章评论(Comment):
|
||||||||||||||||||
|