2064 %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% (J%South%Med%Univ)%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%2009;29(10)

1 2 3 3(1 510405 2
510010 3 510120
(TEAS) -
90 3 30 A + PFVA B TEAS
30%min+PFVA C TEAS 30%

min+PFVA% TEAS A TEAS%30%min A 30%min 5%min

BIS TEAS A

TEAS%30%min A 30%min 5%min 3%mL -

TEAS%30%min A 30%min B C BIS (P<0.05) A

(P>0.05) B C A (P<0.05) C B (P<0.05) BC

A 19%% 27% TEAS B C TEAS%30%min - (P<0.05) C B
(P<0.05) TEAS (P>0.05) TEAS +

R256.205

1673-4254(2009)10-2064-03

Adjuvant effect of transcutaneous electrical acupoint stimulation in propofol-fentanyl

anesthesia in partial mastectomy
SI%Jun-li1,%XU-%lin2,%LI%Guo-cai3,%XIAO%Jian-bin3
Guangzhou% University% of% Traditional% Chinese% Medicine, % Guangzhou% 510405, % China; % 2Department% of% Cardiology, % Guangzhou% General%

Hospital%of%Guangzhou%Command, %Guangzhou%510010, %China; % 3Department%of%Anesthesiology, %Guangdong%Provincial%Hospital%of%

Traditional%Chinese%Medicine,%Guangzhou%510120,%China
Abstract: Objective To% evaluate% the% adjuvant% effect% of% transcutaneous% electrical% acupoint% stimulation% (TEAS) % in%
propofol-fentanyl%anesthesia%in%partial%mastcctomy. %Methods Ninety%patients%undergoing%partial%mastcctomy%were%randomly%
divided%into%3%groups%(n=30),%namely%group%A%with%propofol-fentanyl%anesthesia%(PFVA),%group%B%with%PFVA%and%TEAS%at%
Hegu-Laogong%and%Neiguan-WaiGuan%acupoints, %and%group%C%with%PFVA%and%TEAS%at%Hegu-Laogong, %Neiguan-Waiguan,%
and%bilateral%Jianjing%acupoints.%The%bispectral%index%(BIS),%heart%rate%(HR),%saturation%of%pulse%oxygen%(SpO 2),%blood%pressure%
(BP),%the%reaction%of%patients%to%the%incision%and%awakening%quality%were%observed%at%different%time%points.%Blood%samples%were%
obtained%from%the%dorsal%artery%of%the%foot%to%determine%the%levels%of%adrenaline%and%beta-endorphin%using%the%enzyme-linked%
immunosorbent%assay%before%TEAS%(entry%into%the%OR%in%group%A)%and%at%30%min%after%TEAS%(30%min%after%entry%into%the%OR%
in%group%A),%5%min%after%incision,%end%of%the%surgery%and%awakening.%Results Thirty%minutes%after%TEAS%(or%30%min%after%entry%
into%the%OR%in%group%A),%BIS,%BP%and%HR%were%all%decreased%significantly%in%groups%B%and%C%(P<0.05)%but%remained%stable%in%
group%A%(P>0.05).%The%plasma%propofol%concentration%of%groups%B%and%C%were%significantly%lower%than%that%in%group%A,%and%
group%B%had%the%highest%plasma%propofol%concentration%(P<0.05).%The%total%dose%of%propofol%in%groups%B%and%C%were%decreased%
by% 19%% and% 27%% in% comparison% with% that% in% group% A, % respectively. % Compared% with% the% basal% value, % the% content% of%
beta-endorphin% in% groups% B% and% C% increased% obviously% 30% min% after% TEAS, % being% the% highest% in% group% C% (P<0.05); % the%
adrenaline%level%in%groups%B%and%C%remained%stable%after%TEAS% (P>0.05). %Conclusion TEAS%provides%an%adjuvant%effect%in%
propofol-fentanyl%anesthesia%and%obviously%enhances%the%analgesia%effect.%
Key words: transcutaneous%electrical%acupoint%stimulation;%propofol;%bispectral%index;%adjuvant%effects

TEAS)
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
2009-07-05

1-2 TEAS

3 (BIS) 4

08W04

1981- E-mail: % gztcmsjl777@.

126com
E-mail:%xjb999@tom.com

TCI
BIS

 10

2065

,% .%

4 - 5 -

6 -

1.4%%

SPSS13.0

2008 3 ~2009 5 90

LSD

P<0.05

1%%
1.1%%

2%%
2.1%%

90 ASA

~ 20~65 40~65%kg

(P>0.05)

2.2%%BIS MBP HR
TEAS (A ) TEAS%30%min
A 30%min A BIS MBP
HR B C BIS MBP HR
(P<0.05) TEAS B C
BIS MBP HR
P>0.05 TEAS%30%min A B C
BIS MBP HR P<0.05 C
B P<0.05 ( 1)

1.2%%
90 A B C
30 A +
PFVA B TEAS
30%min+PFVA C TEAS
30%min+PFVA% B
C TEAS LH402
2/100HZ

1%%TEAS%30%min BIS MBP HR

Tab.1 Change of BIS, MBP and HR 30 min after

TEAS%30%min TEAS

3 BIS 555
2.7% g/ml BIS >60 <50 0.3%
g/ml BIS
2.0%g/kg

TEAS (n=30,%MeanSD)
Item

BIS

0.5%g/kg

1.3%%
1.3.1%% TEAS A TEAS%
30%min A 30%min 5%
min BIS

1.3.2%% TEAS A
TEAS%30%min A 30%min
5%min 3%mL 3000%r
min 10%min -80%
Adrenaline% (Ad) Beta-%
endorphin(-EP)

1.3.3%%Ramsay TEAS A
TEAS%30%min A 30%min
5%min Ramsay
Ramsay 1 -
2 - 3 -

MBP mmHg

HR(bpm)

Before%TEAS

96.85.7

TEAS enter%the
OR 30%min
%95.57.0

97.54.2

%%%%%82.25.9*

97.26.1

%%%%%%%75.26.8%*#

92.79.0

%%%%10110.1

92.37.9

%%%%%85.09.2*

91.68.2

%%%%%%80.98.3*#

%%80.510.8

%82.09.1

%%81.911.3

%%%%%%%76.810.2*

Group

enter%the%OR

%%%%%%73.18.2*#

%%81.512.6

*P<0.05%vs before%TEAS P<0.05%vs group%A P<0.05%vs group%B

2.3%%
B C A
(P<0.05) C% B P<0.05 ( 2)
B C A
19% 27%
2.4%%
C (1.00.6)%mg B
(1.2 0.5) % mg A (1.6 0.4) %
mg%(P<0.05)C B P<0.05
B C A 19.6% 23.3% C
B 8.7%

%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% (J%South%Med%Univ)%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% 29
2066

2%% BIS (555)

BIS 100 70

Tab.2 Changes of the target concentration of

<70~40 <40

propofol during the maintenance of the BIS at 555%

BIS 555

(g/ml,%n=30,%MeanSD)

TEAS B C BIS

Group Induction Pre-incision 5%min%after%incision End%of%operation

A

3.00.9

2.70.6

(P<0.05)

3.31.6

%3.00.8

%%2.70.7

%2.40.9

%%2.41.0

%%2.40.3

Ramsay

%%%2.70.3# %2.40.9

%%%2.10.6#

%%%1.70.5#

(P>0.05)

P<0.05%vs group%A #P<0.05%vs group%B

2.5%%Ad -EP
Ad -EP

TEAS Ad

TEAS TEAS

(P>0.05) B C TEAS%30%

-EP TEAS

min -EP (P<0.05) C B

(P<0.05)%( 3)%

TEAS

TEAS

+ TEAS

3%% -

Tab.3 Change of plasma adnephrin and -endorphin levels

perioperatively (MeanSD, n=30)

TEAS

Item Group Before%TEAS

Ad

-EP

TEAS%30%min

Incision%5%min

Awakening

4.290.5

4.310.2

%%4.341.0

4.200.7

4.230.9

4.101.3

%%4.150.9

4.070.8

4.281.2

4.201.0

%%%%4.51.1

4.180.6

28.226.55

29.237.39

%%27.526.49

28.988.05

27.806.39

%%%%32.615.32*

33.899.1

%%36.365.21*

27.896.98 %%%%%35.995.02*#% %%35.905.13 %%%%%38.357.25*#

1 Wang%SM,%Punjala%M,%Weiss%D,%et%a1.%Acupunture%as%an%adjunct%for%

*P<0.05%vs before%TEAS P<0.05%vs group%A#P<0.05%vs group%B

sedation%during%lithotripsy J .%J%Altern%Complement%Med,%2007,%13
(2):%241-6.

2.6%%Ramsay
Ramsay

2 ,% .% J .%
,%2005,%25(2):%129-30.
3 ,% ,% ,% .%

(P>0.05)

J .% ,%2008,%24(8):%726-8.
4 Fassoulaki%A,%Paraskeva%A,%Patris%K,%et%al.%Pressure%applied%on%the%

3%%
TEAS

extra%1%acupressure%point%reduces%bispectral%index%values%and%stress%
in%volunteers J .%Anesth%Analg,%2003,%96:%885-90.
5

Biella% G, % Sotgiu% ML, % PelIcgata% G, % el% a1. % Acupuncture% produces%

central%activations%in%pain%%regions J .%Neuroimage,%2001,%14:%60-6.

5-6

6 Ekblom%A,%Hansson%I,%Fhomsson%M,%et%a1.%Increased%postoperative%

TEAS
TEAS
TEAS
26% 7

pain%and%eonsumption%of%analgesics%following%acupuntture J .%Pain,%

1991,%44:%241-7.
7 ,% ,% ,% .%
J .% ,%2008,%29(8):%1261-3.
8 ,% .%
J .% ,%2006,%26(3):%287-9.

BIS

9 Sandeep%N,%Richard%W,%Andy%J,%et%al.%Surface%electrostimulation%of%

TEAS

acupuncture% points% for% sedation% of% critically% ill% patients% in% the%

intensive% care% unit-a% pilot% study J . % Acupunct% Med, % 2008, % 26 (1): %

1-7.

TEAS BIS

10 Argyro% F, % Anteia% P, % Georgia% K, % et% al. % Acupressure% on% the% extra% 1%

8-10 BIS

acupoint: % the% effect% on% bispectral% index, % serum% melatonin, % plasma%

-endorphin,%and%stress J .

Brief%Report,%2007,%104(2):%312-7.