Protecting action of acupuncture-drug compound anesthesia with different frequency electroacupuncture on stress reaction in patients of pneumonectomy.

Abstract: Objective: To observe the protective effect of acupuncture-drug compound anesthesia with different frequency electroacupuncture (EA) on stress reaction in patients of pneumonectomy and to explore potential mechanisms. Methods: Eighty patients scheduled for pneumonectomy were randomly divided into four groups, group A, B, C and D, 20 cases in each group. General anesthesia and single lung protective mechanical ventilation were carried out in all the groups. Acupuncture was given at Hòuxī (▪ SI 3), Zhīgōu (▪ TE 6), Nèiguān (▪ PC 6), and Hégŭ (▪ LI 4) 30 min before general anesthesia, and the acupuncture needles were connected with Han''s acupoint nerve stimulator (HANS-200) in all the groups, but the acupuncture needles without needle bodies were pasted on the acupoints and EA was not given in the group A. 2 Hz continuous wave, 100 Hz continuous wave and 2 Hz/100 Hz EA were given in the group B, C and D respectively. The supplementary amount of anesthesia medicine, heart rate (HR) and mean arterial pressure (MAP) during pneumonectomy, and CD⁺ ₄/CDCD⁺ ₈ in venous blood before and one day after the surgery, and the contents of epinephrine (E) and Cortisol (Cor) in plasma after entering the operating room and before turning out the operating room were detected. Results: ▪ During the operation, supplementary amounts of Fentanyl in the group B and C were lower than those in the group A and D (P<0.05, P<0.01). ▪ The MAP in the four groups at tracheal intubation (T₁) all were higher than those before anesthesia (T₀) (all P<0.01), and the ascending extents in the group B, C and D were lower than that in the group A (all P<0.01); HR at T₁ in the group A was higher than that at T₀ (P<0.05), while no significant change in the other groups (all P>0.05), and the ascending extents in the group B and D were lower than that in the group A (both P<0.05); MAP and HR at the other moments in all the groups were stable. ▪ CD⁺ ₄/CD⁺ ₈ in the group A after pneumonectomy was lower than that before the surgery (P<0.05), while no significant change in the other groups (all P>0.05). ▪ Contents of E and Cor after the operation were significantly increased in all the groups (all P<0.01), and the ascending extent of E content in the group D was lower than that in the group A (P<0.05); the ascending level of Cor in the group B and D was lower than that in the group A (P<0.01), and in the group B was lower that in the group C and D. Conclusion: Acupuncture-drug compound anesthesia can attenuate the stress reaction so as to protect organs under the condition of less or same narcotic amount and can alleviate the fluctuation of MAP and HR at tracheal intubation and stabilize CD⁺ ₄/CD⁺ ₈ after pneumonectomy. Among them, 2 Hz and 2 Hz/100 Hz EA have better effects. [Copyright &y& Elsevier]