中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2016, Vol. 45 ›› Issue (4): 345–348.doi: 10.12007/j.issn.0258-4646.2016.04.014

• 论著 • 上一篇    下一篇

经皮穴位电刺激与右美托咪定对腹腔镜手术患者术后早期 认知功能的影响

朱俊超,滕秀飞,杨延超,万玉骁,李阳   

  1. 中国医科大学附属盛京医院麻醉科,沈阳 110004
  • 收稿日期:2015-12-01 出版日期:2016-04-28 发布日期:2016-04-05
  • 作者简介:朱俊超(1974 -),女,副教授,博士.
  • 基金资助:
    中国医科大学附属盛京医院三新项目(2015PS57J)

Effects of Transcutaneous Acupoint Electrical Stimulation and Dexmedetomidine on Postoperative Cognitive Dysfunction in Patients Underwent Laparoscopic Surgery

ZHU Jun-chao,TENG Xiu-fei,YANG Yan-chao,WAN Yu-xiao,LI Yang   

  1. Department of Anesthesiology,Shengjing Hospital,China Medical University,Shenyang 110004,China
  • Received:2015-12-01 Online:2016-04-28 Published:2016-04-05

摘要: 目的 比较经皮穴位电刺激与右美托咪定(Dex)对妇科行腹腔镜手术患者术后认知功能的影响。方法 选取于我院择期行妇科腹腔镜手术的患者 90 例,随机分成对照组(C 组,n =30)、经皮穴位电刺激组(T 组,n =30)和右美托咪定组(D 组,n =30)。麻醉诱导前 30 min,对 T 组患者内关、足三里穴位进行电刺激并持续至术毕,D 组在麻醉诱导前给予 Dex 0.5 μg/kg,10 min静脉泵入,3 组患者均常规麻醉诱导和维持。记录患者术后拔管时间,于术前、术毕及术后 24 h 留取外周静脉血,测定 S100β水平。分别于术前和术后 24 h 进行简易智力状态检查量表(MMSE)评分,评估术后认知功能障碍(POCD)发生情况。结果 T、D组术毕及术后 24 h 血清 S100β浓度及术后 POCD 的发生率较 C 组低(P < 0.05),D 组拔管时间及在 PACU 停留时间较 C 组和 T 组延长,且心动过缓的发生率更高(P < 0.05)。结论 经皮穴位电刺激和 Dex 均可降低全麻患者 POCD 的发生率,但经皮穴位电刺激的不良反应发生率更低。

关键词: 经皮穴位电刺激, 右美托咪定, 术后认知功能障碍, 腹腔镜手术

Abstract: Objective To observe the effect of transcutanous acupoint electrical stimulation(TAES)and dexmedetomidine on postoperative cognitive dysfunction in female patients underwent laparoscopic surgery. Methods Nighty patients scheduled for laparoscopic surgery were recruited in this study and randomly divided into control group(group C,n =30),TAES group(group T,n = 30)and dexmedetomidine group(group D,n =30). In group T,patients received TAES treatment 30 min before the anesthesia until the end of the surgery at Neiguan(PC 6)and Zusanli(ST36). The frequency was 2/100 Hz. In group D,patients were intravenously administrated with dexmedetomidine(0.5 μg/kg)before the induction.All the patients were given routine general anesthesia. Drugs induced were sulfentanyl,etomidate and cisatracurium. Sevoflurane was given to maintain the bispectral index(BIS)between 40 and 55. The time of extubation and in PACU was recorded. The serum S100β level was assessed at preoperation(T0),the end of operation(T1)and 24 h after operation(T2). Mini-mental state examination(MMSE)was adopted to evaluate and record the changes in cognitive function 1 day before operation and 24 h after operation. Results The incidence rate of POCD in group T and group D were lower than that in group C(all P < 0.05). The level of S100β in group T and group D was lower than those in group C at T1 and T2 separately(all P < 0.05). The time of extubation and time in PACU in group D were longer than those in group C and group T(all P < 0.05),and the incidence of bradycadia in group D was higher than that in the other groups(all P < 0.05). Conclusion TAES and dexmedetomidine reduce the incidence of cognitive dysfunction,decrease the release of S100β protein. However,dexmedetomidine increases bradycadia,and prolongs extubation time and stay time in PACU. Hence,TAES deserve to be recommended practically.

Key words: transcutaneous acupoint electrical stimulation, dexmedetomidine, postoperative cognitive dysfunction, laparoscopic surgery

中图分类号: 

  • R614.2
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