[Impacts of electroacupucnture at Zusanli (ST 36) and Feishu (BL 13) on the postoperative inflammatory reaction and pulmonary complications in senile patients after radical resection of pulmonary carcinoma].

OBJECTIVE: To observe the impacts of electroacupuncture (EA) at Zusanli (ST 36) and Feishu (BL 13) applied 30 min before the operation till the end of the operation on the postoperative inflammatory reaction and pulmonary complications in the senile patients after radical resection of pulmonary carcinoma. METHODS: Eighty senile patients of pulmonary carcinoma were selected and randomized into an observation group and a control group, 40 cases in each one. In the observation group, EA stimulation at Zusanli (ST 36) and Feishu (BL 13) was used 30 min before the operation till the end of the operation. In the control group, electric stimulation was not used. Separately, before operation (T1, basic state), 12 h after operation (T2) and 24 h after operation (T3), blood sample was collected from the central vein. The concentrations of plasma tumor necrosis factor-ɑ (TNF-ɑ) and interleukin-10 (IL-10) were detected. Additionally, the radial arterial blood sample was collected at the above time points; oxygen partial pressure (PaO2) was determined; pulmonary alveoli-arterial partial pressure of oxygen (PA-aDO2) and oxygenation index (OI) were calculated. The pulmonary complication in the two days after operation was recorded. RESULTS: Compared with the control group, in the observation group, at T2 and T3, TNF-ɑ concentration and PA-aDO2 were lower (all P<0.05); plasma IL-10 concentration and OI were higher (all P<0.05). In the observation group, the incidences of postoperative pneumonia and acute pulmonary injury were lower than those in the control group (both P<0.05). CONCLUSIONS: EA reduces the postoperative inflammatory reaction in the senile patients with radical resection of pulmonary carcinoma and decreases the postoperative pulmonary complicattizen.

[Impacts of transcutaneous acupoint electric stimulation on the postoperative nausea and vomiting and plasma 5-HT concentration after cesarean section].

OBJECTIVE: To observe the effect of transcutaneous acupoint electric stimulation on the postoperative nausea and vomiting (PONV) and explore its mechanism. METHODS: Ninety cases of elective cesarean section of I to II grade in American Society of Anesthesiologists (ASA) were collected and randomized into a transcutaneous acupoint electric stimulation group (group A), a sham-acupoint group (group B) and a blank control group (group C), 30 cases in each one. In the group A, 30 min before operation, the transcutaneous electric stimulation was applied to bilateral Neiguan (PC 6) and Zusanli (ST 36). The stimulation lasted during operation and 1 h after operation. In the group B, the same electric stimulation was given at the sites 3 cm lateral to the medial sides of Neiguan (PC 6) and Zusanli (ST 36). In the group C, the electric plaster was attached to bilateral Neiguan (PC 6) and Zusanli (ST 36), without any electric stimulation. The lumbar epidural combined anesthesia and the postoperative analgesia were same in each group. The mean arterial pressure (MAP), heart rate (HR) , oxygen saturation of blood (SpO2) and the VAS (visual analogue scale) score of nausea and vomiting were recorded before acupoint stimulation (T0), at skin incision (T1), fetal delivery (T2), abdominal exploration (T3) and 1 h after operation (T4) as well as bleeding and application of oxytocin, ephedrine and atropine during operation separately. The changes of plasma 5-hydroxytryptamine (5-HT) concentration were observed at T0 and 30 min after electric stimulation. RESULTS: The differences were not significant in MAP, HP and SpO2 at each time point of the three groups (all P> 0.05). The differences were not significant in bleeding and application of oxytocin, ephedrine and atropine during operation (all P > 0.05). The scores of nausea and vomiting in the group A during T1 to T4 were lower than those in the group B and group C (all P < 0.05). In the group A, 30 min after transcutaneous acupoint electric stimulation, plasma 5-HT concentration was lower than those in the group B and group C (both P < 0.01). CONCLUSION: The transcutaneous acupoint electric stimulation apparently relieves nausea and vomiting during and after cesarean section and the mechanism is relevant with the decrease of plasma 5-HT concentration.

[Influence of auricular point sticking on incidence of nausea and vomiting and analgesia effect after gynecological laparoscopy].

OBJECTIVE: To observe the influence of auricular point sticking on incidence of nausea and vomiting and analgesia effect after gynecological laparoscopy, and provide evidence for clinical application of auricular point sticking. METHODS: One hundred and twenty cases of selective gynecological laparoscopy under general anesthesia were randomly divided into an auricular point sticking group and a placebo group, 60 cases in each group. In the auricular point sticking group, the auricular point sticking with vaccaria seeds was applied at Shenmen (TF 4), Wei (CO 4) and Jiaogan (AH 6a) before the operation and 1, 5, 9, 23 h after the operation, which were pressed 5 min each point each time. The two ears were proceeded at the same time. In the placebo group, the same point selection, sticking paste was used as the auricular point sticking group, but no sticking or pressing with vaccaria seeds was adopted. The incidence of nausea and vomiting, the usage rate of tropisetron and morphine within 24 hours of the operation, as well as the score of visual analogue scale (VAS) and other adverse reactions at 2, 6, 10, 24 h after the operation were observed respectively. RESULTS: Compared with the placebo group, the incidence of nausea and vomiting [31.7% (19/60), 16.7% (10/60) vs 58.3% (35/60), 35.0% (21/60)], the usage rate of tropisetron [21.7% (13/60) vs 48.3% (29/60)] and morphine [18.3% (11/60) vs 38.3% (23/60)], the VAS scores at all different time points in the auricular point sticking group were all decreased (all P < 0.05), and no adverse reaction was observed. CONCLUSION: The auricular point sticking could significantly decrease the incidence of nausea and vomiting in patients of gynecological laparoscopy and has positive analgesic effect.

[Effects of transcutaneous electrical stimulation of auricular Shenmen point on postoperative nausea and vomiting and patient-controlled epidural analgesia in cesarean section].

OBJECTIVE: To investigate the effects of transcutaneous electrical stimulation of auricular Shenmen point on postoperative nausea and vomiting and patient-controlled epidural analgesia in cesarean section. METHODS: After IRB approval and informed consent, one hundred and eighty singleton primiparas undergoing elective cesarean section, in Qingdao Municipal Hospital, and Qingdao Hiser Medical Center, from November 2011 to March 2012, were randomly assigned to three groups: transcutaneous electrical stimulation of auricular Shenmen point group (group A, n = 60), transcutaneous electrical stimulation of auricular Eye point group (group B, n = 60) and control group (group C, n = 60). Women of group A received transcutaneous electrical stimulation of auricular Shenmen point (frequency 1.5 HZ) at the time of preoperation, 4, 10 and 22 hours of postoperation for 30 minutes. The strength was controlled by themselves. Women of group B received stimulation of auricular Eye point as group A. Women of group C received pressurization and connected line were the same with group A, but without electrical stimulation. The following indexes was observed: the incidence of postoperative nausea and vomiting (PONV) for 48 hours; the rate of metoclopramide; the visual analogue scale (VAS) score of rest pain, uterine contration pain and dynamic pain at the time of postoperation for 6, 12, 24 and 48 hours (T(1)-T(4)); the total number and effective compressions number of patient-controlled epidural analgesia(PCEA);the dose of analgesia mixture; the anal exhaust time; the volume of postoperative bleeding for 6 hours of postoperation and the other side effects. RESULTS: Compared with group B and group C, the incidence of PONV, the rate of metoclopramide, the VAS score at the time T(1)-T(4), the total number and effective compressions number of PCEA, the ratio of the total number with effective compressions number and the dose of analgesia mixture were decreased in group A (P < 0.05), but no difference compared group B with group C (P > 0.05). The anal exhaust time and the volume of postoperative bleeding for 6 hours of postoperation were no difference in the three groups (P > 0.05). No other side effects were observed. CONCLUSION: Transcutaneous electrical stimulation of auricular Shenmen point can reduce the incidence of PONV and improves analgesia effect of PCEA in postoperation of cesarean section.

[Efficacy and safety of patient-controlled sedation with transcutaneous electrical stimulation of auricular Shenmen (TF4) in cesarean section].

OBJECTIVE: To study the efficacy and safety of patient-controlled sedation with transcutaneous electrical stimulation of auricular Shenmen (TF4) in cesarean section. METHODS: A randomized controlled clinical trail was conducted on 180 singleton primiparas (SAS > 30) undergoing selective cesarean section. They were randomly assigned to three groups, i. e., the patient-controlled sedation with transcutaneous electrical stimulation of auricular Shenmen (TF4) group (Group A, 60 cases), the patient-controlled sedation with transcutaneous electrical stimulation of auricular eye point group (Group B, 60 cases), and the control group (Group C, 60 cases). Patients in Group A received patient-controlled sedation with transcutaneous electrical stimulation of auricular Shenmen (TF4) in the operating room. The strength was controlled by patients themselves. The stimulation lasted for 30 min before the epidural puncture till ending the surgery. Patients in Group B received stimulation of auricular eye point. Patients in Group C received pressurization with the same connected line as Group A, but without electric stimulation. The following indices were observed: (1) the bispectral index (BIS), heart rate (HR), mean arterial pressure (MAP), Ramsay sedation score when the women entered the operating room (T0), 30 min after stimulation (T1), at the time after removing the fetus (T2), and by the end of surgery (T3); (2) the concentrations of plasma angiotensin II (AngII) and cortisone (Cor) at the aforesaid time points; (3) the use rates of oxytocin, atropine, and ephedrine; the hemorrhage amount, and the neonatal Apgar score. RESULTS: Compared with Group A, the BIS, the plasma concentrations of AngII and Cor increased at T1, T2, and T3 (P < 0.05), and the Ramsay sedation score decreased (P < 0.05). The HR and MAP increased at T1 (P < 0.05) in Group B and Group C. Compared with T0, the BIS, HR, MAP, and Ramsay sedation score, the plasma concentrations of AnglI and Cor were lowered in Group A at T1 (P < 0.05). There was no statistical difference in the use rates of oxytocin, atropine, and ephedrine; the hemorrhage amount, and the neonatal Apgar score (P > 0.05). CONCLUSIONS: Patient-controlled sedation with transcutaneous electrical stimulation of auricular Shenmen (TF4) in cesarean section had obvious sedative effects. It had no adverse effects on puerperal or neonates.