李井柱 1郑丽莉 1王明山 1刘玉秋 1时飞 1毕燕琳 1马福国 1何娟2
作者信息
- 1. 青岛大学医学院附属青岛市市立医院麻醉科 山东266071
- 2. 青岛大学医学院附属青岛市市立医院检验科 山东266071
- 折叠
摘要
Abstract
conscious sedation; acupuncture; auricular shenmen (TF4); electrical stimulation therapy; cesarean section; angiotensin Ⅱ ; hydrocortisone 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 (Angll) and cortisone (Cor) at the aforesaid time points; (3) the use rates of oxytocin, atro-pine, and ephedrine; the hemorrhage amount, and the neonatal Apgar score. Results Compared with Group A, the BIS, the plasma concentrations of Angll 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 Angll 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.关键词
清醒镇静/针刺,神门穴/电刺激疗法/剖宫产术/血管紧张素Ⅱ/氢化可的松Key words
conscious sedation/ acupuncture/ auricular shenmen (TF4)/ electrical stimulation therapy/ cesarean section/ angiotensin Ⅱ / hydrocortisone
