We randomly divided 80 patients who underwent elective surgery into 4 groups: group etomidate (ETO), group etomidate + electroacupuncture (ETO+EA), group etomidate + sham acupuncture (ETO+SEA), and group propofol (PRO).
Sample Count
80
Age
18-75
Control
Sham
Std
group etomidate (ETO)(n=20); group etomidate + sham acupuncture (ETO+SEA)(n=20); group propofol (PRO)(n=20)
Experiment
group etomidate + electroacupuncture (ETO+EA)(n=20)
The patients in group ETO, ETO+EA, and ETO+SEA were induced with etomidate and sufentanil and maintained with intravenous infusion of etomidate and remifentanil. Group PRO was induced with propofol and sufentanil and maintained with propofol and remifentanil. Premedication in all 4 groups consisted of pethidine 50 mg, promethazine 25 mg, and scopolamine 0.3 mg intramuscularly 45 min before transport to the operating room.After administration of 0.05 mg/kg midazolam, 0.4 mug/kg sufentanil, and 0.5 mg/kg atracurium, anesthesia was induced with either 0.3 mg/kg etomidate in group ETO, ETO+EA, and ETO+SEA or 2 mg/kg propofol in group PRO. Intubation was performed when muscles had relaxed, then the ventilation was adjusted to keep end-tidal carbon dioxide at 35-40 mmHg. Anesthesia was maintained with etomidate at a constant rate of 0.6 mg/kg/h in group ETO, ETO+EA, and ETO+SEA or 6 mg/kg/h propofol in group PRO. In addition, remifentanil was infused at a constant rate of 0.35 mug/kg/min in all 4 groups. To maintain muscle relaxation, 0.25 mg/kg atracurium was injected repeatedly whenever deemed necessary by the anesthesiologist.
gradually increased from zero to reach a strong but comfortable level
throughout the operation
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
-
-
The depth of needle insertion depended on the acupoints selected.
Description Electrical stimulation was delivered via a battery-operated stimulator (model WQ1002K, AERON Optoelectronic Technology Corp., Beijing, PRC) that emitted dense-sparse waves (dense wave: 18 Hz, duration time 1.05 sec; sparse wave: 3.85 Hz, duration time 2.85 sec) [16,17]. The stimulator was then switched on, and the intensity was gradually increased from zero to reach a strong but comfortable level.
Anesthesia Method
AAA
Clinical Trial Type
random
Contraindications
Previous history of acupuncture or emulsion allergies
Effector
Cortisol concentrations were significantly higher at all times except T0 in group ETO+EA compared with group ETO. The ACTH concentrations were lower in group ETO+EA than that in group ETO at point T3. Electroacupuncture at ST 36 and SP 6 can mitigate the adrenal cortical inhibition induced by etomidate and can reduce the secretion of catecholamines during surgery.
Effect of electroacupuncture at Zusanli (ST36) and Sanyinjiao (SP6) acupoints on adrenocortical function in etomidate anesthesia patients.
Abstract
BACKGROUND: We aimed to investigate the effect of electroacupuncture at Zusanli (ST36) and Sanyinjiao (SP6) on adrenocortical function in patients with etomidate anesthesia. MATERIAL AND METHODS: We randomly divided 80 patients who underwent elective surgery into 4 groups: group etomidate (ETO), group etomidate + electroacupuncture (ETO+EA), group etomidate + sham acupuncture (ETO+SEA), and group propofol (PRO). The patients in group ETO, ETO+EA, and ETO+SEA were induced with etomidate and sufentanil and maintained with intravenous infusion of etomidate and remifentanil. Group PRO was induced with propofol and sufentanil and maintained with propofol and remifentanil. Group ETO+EA received electro-acupuncture stimulation at Zusanli and Sanyinjiao throughout the operation, while group ETO+SEA received electro-acupuncture stimulation at non-acupoints. We recorded the values of MAP, HR, BIS, CVP, cortisol, ACTH, epinephrine, norepinephrine, and arterial blood gas during the perioperative period. RESULTS: Cortisol concentrations were significantly higher at all times except T0 in group ETO+EA compared with group ETO. The ACTH concentrations were lower in group ETO+EA than that in group ETO at point T3. CONCLUSIONS: Electroacupuncture at ST 36 and SP 6 can mitigate the adrenal cortical inhibition induced by etomidate and can reduce the secretion of catecholamines during surgery."
Souce
Med Sci Monit. 2014 Mar 12;20:406-12. doi: 10.12659/MSM.890111.
