周斌福 1倪艳乐 1瞿清 1戴卫平 1叶晓品 2项大业 3王建友4
作者信息
- 1. 浙江省乐清市第二人民医院麻醉科,乐清,325608
- 2. 浙江省乐清市第二人民医院针灸科,乐清,325608
- 3. 浙江省乐清市第二人民医院骨科,乐清,325608
- 4. 浙江省乐清市第二人民医院检验科,乐清,325608
- 折叠
摘要
Abstract
Objective To investigate the effects of transcutaneous electrical acupoint stimulation (TEAS) combined with controlled hypotension on early postoperative cognitive dysfunction (POCD) under sevoflurane anesthesia in spinal surgery. Methods Seventy five patients between 45 and 65 years, scheduled for single spinal surgery with ASA I ~ Ⅲ, were randomly divided into controlled hypotension combined with TEAS group (group T, n=36) and regularly controlled hypotension group (group N, n=39). All patients received general anesthesia for tracheal intubation and maintained with inhalation sevoflurane (BIS:45~55). In group N, controlled hypotension was performed with nitroglycerin intravenously until MAP decreased by about 30% with the lowest limited above 55 mmHg. In group T, HAN'S TEAS at Hegu, Quchi, Zusanli, Sanyinjiao was continued from 30 minutes before anesthesia to the end of the operation, and maintained with the same level of the pressure as group N by controlled hypotension. Mini-metal state examination (MMSE) and the level of serum S100 protein were assessed at preoperative, postoperative 1 d, 3 d, 5 d respectively. POCD was diagnosised when MMSE score declined 2 compared with baseline. Results Among the patients studied, there was no significant difference between the two groups before the operation. At postoperative 1 d, POCD incidence was 15(38.5%) in group N, 5(13.9%) in group T (P<0.01). At postoperative 3 d, POCD incidence was 7(17.9%) in group N, 3 (8.3%) in group T(P<0.05). At postoperative 5 d, the prevalence of cognitive dysfunction was similar between the two groups. At postoperative 1 d, 3 d, 5 d the level of serum S100 protein of the two groups was higher than that before the operation, and compared with group N, the level of group T's serum S100 protein was significant lower at all times(P<0.01,P< 0.05) exclude at postoperative 5 d. Conclusion Controlled hypotension combined with TEAS under sevoflurane anesthesia when applied to single spinal surgery should decrease the incidence of POCD.关键词
控制性降压/术后认知功能障碍/经皮穴位电刺激Key words
controlled hypotension/ postoperative cognitive dysfunction/ transcutaneous electrical acupoint stimulation分类
医药卫生
