Effects of electroacupuncture on postoperative acute lung injury in patients with acute abdomen complicated with abdominal infection / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the effects of electroacupuncture (EA) on postoperative acute lung injury (ALI) in patients with acute abdomen complicated with abdominal infection.Methods Ninety patients of both sexes with acute abdomen complicated with abdominal infection,with body mass index of 18-30 kg/m2,aged 35-64 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective abdominal surgery with general anesthesia,were divided into 3 groups (n =30 each) using a random number table method:control group (group C),EA at acupoint group (group E) and EA at non-acupoint group (group N).Anesthesia was induced with midazolam,propofol,cis-atracurium and sufentanil.The patients were mechanically ventilated after tracheal intubation.Anesthesia was maintained with inhalation of sevoflurane,Ⅳ infusion of propofol and cis-atracurium and intermittent Ⅳ boluses of sufentanil.At 15 min of anesthesia induction,2 h after skin incision and 2,12 and 24 h after tracheal intubation,Hegu,Zusanli and Neiguan acupoints were stimulated for 15 min every time in group E,and the points 1 cm lateral to the acupoints of Hegu,Zusanli and Neiguan were stimulated for 15 min every time in group N,with disperse-dense waves,frequency 2/15 Hz,wave length 0.2-0.6 ms,at a voltage of 1-2 mA.Arterial blood samples were collected at 15 min before induction (T1) and 24 and 48 h after operation (T2 and T3) for blood gas analysis,oxygenation index was calculated,and the development of ALI (oxygenation index ＜ 300 mmHg) was recorded at T2 and T3.The concentrations of club cell protein 16 (CC16),surfactant protein D (SP-D),soluble receptor for advanced glycation end products (sRAGE),interleukin-1 (IL-1),IL-10,and tumor necrosis factor-alpha (TNF-α) in serum were detected by enzyme-linked immunosorbent assay.Results Compared with the baseline at T1,the serum concentrations of CC16,SP-D,sRAGE,IL-1 and TNF-α were significantly increased,and the serum IL-10 concentrations were decreased at T2 in C,E and N groups (P＜0.05).Compared with group C,the serum concentrations of CC16,SP-D,sRAGE,IL-1 and TNF-α were significantly decreased,and the serum IL-10 concentrations were increased at T2 and T3,and AI was increased at T3 in group E (P＜0.05).There was no significant difference in the incidence of ALI at T2 and T3 among three groups (P＞0.05).Conclusion Although EA does not decrease the occurrence of ALI,it mitigates the degree of ALI to some extent in the patients with acute abdomen complicated with abdominal infection.