The 52 patients consented to enrolment and were assigned to receive either TENS (n = 26) on bilateral ST36 and SP6 acupoints with continuous mode at a frequency of 15 Hz and the intensity of 10 mA synchronously for 30 min or non-stimulation (placebo group, n = 26) preoperatively.
Sample Count
54
Control
Placebo
non-stimulation(placebo group)(n=26)
Experiment
TENS(n=26)
Indicator
HemodynamicsBlood glucosePlasma insulin
Auxiliary Medication
General anaesthesia was induced with intravenous fentanyl (2ugkg-1), thiamylal sodium (4.0-5.0mgkg-1), lidocaine (1mgkg-1) and rocuronium bromide (0.8-1.0 mgkg-1) for facilitating tracheal intubation. As opioids affect glucose metabolism, we gave the same dosage of fentanyl between TENS group and placebo group when general anaesthesia was induced. The anaesthesia was maintained by 2.0±0.5% sevoflurane in oxygen throughout the duration of surgery for all patients. No additional opioid analgesics were given intraoperatively.
Stimulation Method
TENS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
HANS LY257
Healthronics, Singapore, Singapore
15 Hz
continuous wave
10 mA
30 min
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
-
-
-
Description The TENS stimulator was set to stop automatically within 30 min by the manufacturer (with continuous mode at a frequency of 15 Hz and the intensity of 10 mA).
Anesthesia Method
AAA
Clinical Trial Type
random
Contraindications
Inserted pace maker
Effector
At baseline, there was no significant difference between the TENS group and the placebo group in plasma glucose and insulin levels as well as homeostasis model assessment (HOMA) index. In the placebo group, plasma glucose, insulin and HOMA index increased during induction of general anaesthesia, surgical incision, and throughout the operation. Plasma glucose and insulin levels as well as HOMA index were significantly lower in the TENS group as compared to the placebo group at different time points after discontinuation of TENS application. These results indicate the positive effect of prevention of hyperglycaemia and the increased sensitivity of plasma insulin in the TENS group.
Transcutaneous electrical nerve stimulation on ST36 and SP6 acupoints prevents hyperglycaemic response during anaesthesia: a randomised controlled trial.
Abstract
BACKGROUND AND OBJECTIVE: Hyperglycaemia is a common result of stress signals caused by pain and surgical procedure. Volatile anaesthetics also directly manipulate glucose homeostasis by affecting pancreatic insulin release and induce hyperglycaemia without surgical stress. We determined the preoperative application of transcutaneous electrical nerve stimulation (TENS) to the Chinese acupoints ST36 (Zusanli) and SP6 (Sanyinjiao) as a complementary therapy for controlling plasma glucose and improving insulin resistance during anaesthesia. METHODS: We designed a single-blind, randomised controlled clinical study of female patients, scheduled for elective hysterectomy. The 52 patients consented to enrolment and were assigned to receive either TENS (n = 26) on bilateral ST36 and SP6 acupoints with continuous mode at a frequency of 15 Hz and the intensity of 10 mA synchronously for 30 min or non-stimulation (placebo group, n = 26) preoperatively. Haemodynamics, blood glucose and plasma insulin were measured during general anaesthesia. RESULTS: At baseline, there was no significant difference between the TENS group and the placebo group in plasma glucose and insulin levels as well as homeostasis model assessment (HOMA) index. In the placebo group, plasma glucose, insulin and HOMA index increased during induction of general anaesthesia, surgical incision, and throughout the operation. Plasma glucose and insulin levels as well as HOMA index were significantly lower in the TENS group as compared to the placebo group at different time points after discontinuation of TENS application. These results indicate the positive effect of prevention of hyperglycaemia and the increased sensitivity of plasma insulin in the TENS group. CONCLUSION: We found TENS at bilateral ST36 and SP6 acupoints to be an alternative means of managing the plasma glucose level and improving insulin resistance perioperatively."
