经皮穴位电刺激手环行内关穴刺激对全麻甲状腺切除术后恶心呕吐的影响

Effect of transcutaneous electrical acupoint stimulation bracelet at Neiguan acupoint on postoperative nausea and vomiting after thyroidectomy under general anesthesia

中文关键词: 经皮穴位电刺激  甲状腺切除术  术后恶心呕吐  内关穴  手环

英文关键词: Transcutaneous electrical acupoint stimulation  Thyroidectomy  Postoperative nausea and vomiting  Neiguan acupoint  Bracelet

中文摘要:

      
目的：探讨围术期采用经皮穴位电刺激手环行内关穴刺激对全麻甲状腺切除术后恶心呕吐的影响。
方法：选择择期在全麻下行甲状腺切除术的女性患者72例，年龄18～50岁，ASA Ⅰ或Ⅱ级。采用可变区组随机化将患者1∶1随机分配入两组：电刺激组和对照组，每组36例。两组患者均在麻醉诱导前佩戴国产经皮穴位电刺激手环，电极对准内关穴。电刺激组开机刺激内关穴，调整强度使患者感觉手部关联区域有麻刺感且可耐受，固定手环后关机；手术结束时立即打开手环，给予麻醉诱导前确定的刺激强度，持续佩戴24 h。对照组同样佩戴24 h，但始终不通电。记录术后24 h内术后恶心呕吐（PONV）例数及止吐药物的使用情况。
结果：与对照组比较，电刺激组术后24 h内PONV发生率、术后呕吐发生率明显降低（P<0.05），且差异主要出现在术后1～6 h（P<0.05）。两组不同时间段止吐药物补救率差异无统计学意义。
结论： 采用穿戴式手环行经皮内关穴电刺激可以有效降低甲状腺切除术后24 h内PONV发生率。

英文摘要:

      
Objective: To explore the effect of transcutaneous electrical acupoint stimulation bracelet at Neiguan acupoint on the postoperative nausea and vomiting after thyroidectomy under general anesthesia.
Methods: Seventy-two female patients underwent thyroidectomy, aged 18-50 years, ASA physical status Ⅰ or Ⅱ, were enrolled. The patients were assigned 1:1 to two groups by permuted block randomization: the electrical stimulation group and the control group, 36 patients in each group. Before anesthesia induction, patients in both groups wore domestic transcutaneous electrical acupoint stimulation bracelets, and the electrodes were aimed at Neiguan acupoint. The electrical stimulation group started to stimulate Neiguan acupoint, and adjusted the proper intensity to make the patient feel tingling in the related area of the hand. When the bracelet was fixed firmly, turned it off. At the end of the operation, the bracelet was turned on with the stimulation intensity set before induction for 24 hours. Patients in the control group also wore the bracelet for 24 hours, but it was never turned on. The number of cases of postoperative nausea and vomiting (PONV) and the number of remedial cases of antiemetic drugs were recorded.
Results: Compared with the control group, the incidence of PONV and postoperative vomiting in the electrical stimulation group were significantly reduced within 24 hours after surgery (P < 0.05), and the differences were mainly in 1-6 hours after surgery (P < 0.05). There was no significant difference in the rate of remedial cases of antiemetic drugs between the two groups at different time periods.
Conclusion: Transcutaneous electrical stimulation bracelet at Neiguan acupoint can effectively reduce the incidence of PONV within 24 hours after thyroidectomy.