Description at bilateral Neiguan (PC 6), Lieque (LU 7), and Yunmen (LU 2)
Experimental Description
Sixty patients with acquired heart valve disease were randomly allocated to the EA pretreatment group or the control group.
Sample Count
60
Control
Sham
control group(n=30)
Experiment
EA pretreatment group(n=30)
Indicator
Length of mechanical ventilation in the ICUDuration of stay in the ICUTotal volume of blood transfusionTotal volume of chest drainageComplications after the operationInotrope scoresTroponin I
Auxiliary Medication
The bispectral index was used to measure the depth of sedation and maintained from 40 to 60. Anesthesia was induced and maintained by propofol, fentanyl, and vecuronium.
Stimulation Method
EA
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
Hwato SDZ-II
Suzhou Medical Appliances Co. Ltd, Suzhou, China
5/30 Hz
-
0.8-1.9 mA
30 min
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
26 to 30 gauge and 0.5 to 2.5 inches long
Suzhou Hua Tuo Medical Instruments Co., Ltd., Suzhou, China
-
Description Original needles, 26 to 30 gauge and 0.5 to 2.5 inches long, manufactured of austenitic stainless steel (Suzhou Hua Tuo Medical Instruments Co, Ltd, Suzhou, China), were employed for the electroacupuncture. The 1.5 inch needles were used to stimulate Neiguan (PC 6) and Lieque; the 2.0 inch needles were used to stimulate Yunmen (LU 2).After the needles were inserted into the acupuncture points, the points were stimulated electrically with the intensity of 0.8 to 1.9 mA and frequency of 5/30 Hz for 30 minutes using the Hwato electronic acupuncture treatment instrument (model No. SDZ-II; Suzhou Medical Appliances Co, Ltd, Suzhou, China) until the patient felt the so-called "Teh Chi" sensations of heaviness, numbness, and swelling.
Anesthesia Method
GA
Clinical Trial Type
random
Contraindications
Patients who presented with other systemic diseases such as hepatic, renal, and pulmonary diseases, or have had a heart operation before, were excluded. Additionally, patients taking antidiabetic sulfonylurea or glibenclamide were excluded because these agents have been shown to abrogate the cardioprotection elicited by ischemic preconditioning
Effector
At 6 hours, 12 hours, and 24 hours after reperfusion, levels of serum cardiac troponin I were significantly decreased in the EA group (5.74 +/- 0.67, 6.22 +/- 0.66, and 5.21 +/- 0.58) compared with that in the control group (7.89 +/- 0.74, 8.34 +/- 1.08, and 7.57 +/- 0.89, p < 0.05). The EA pretreatment significantly reduced overall serum troponin I release at 6 hours, 12 hours, and 24 hours after aortic cross-clamp removal. Meanwhile, EA pretreatment also reduced the inotrope score at 12 hours, 24 hours, and 48 hours after the intensive care unit arrival and shortened intensive care unit stay time (p < 0.05).
Cardioprotective effects of electroacupuncture pretreatment on patients undergoing heart valve replacement surgery: a randomized controlled trial.
Abstract
BACKGROUND: Cardiac ischemia-reperfusion injury after cardiopulmonary bypass contributes to postoperative morbidity and mortality in patients with open-heart surgery. This randomized controlled trial was designed to address the protective effects of electroacupuncture (EA) pretreatment on myocardial injury in patients undergoing heart valve replacement surgery. METHODS: Sixty patients with acquired heart valve disease were randomly allocated to the EA pretreatment group or the control group. Patients in the EA group received EA stimulus at bilateral Neiguan (PC 6), Lieque (LU 7), and Yunmen (LU 2) for 30 minutes each day for five consecutive days before surgery. Hemodynamic data, mechanical ventilation time, inotropic drug use in the intensive care unit, serum cardiac troponin I concentrations, morbidities, and mortalities were compared between the two groups. This trial is registered with ClinicalTrials.gov, number NCT00732459. RESULTS: At 6 hours, 12 hours, and 24 hours after reperfusion, levels of serum cardiac troponin I were significantly decreased in the EA group (5.74 +/- 0.67, 6.22 +/- 0.66, and 5.21 +/- 0.58) compared with that in the control group (7.89 +/- 0.74, 8.34 +/- 1.08, and 7.57 +/- 0.89, p < 0.05). The EA pretreatment significantly reduced overall serum troponin I release at 6 hours, 12 hours, and 24 hours after aortic cross-clamp removal. Meanwhile, EA pretreatment also reduced the inotrope score at 12 hours, 24 hours, and 48 hours after the intensive care unit arrival and shortened intensive care unit stay time (p < 0.05). CONCLUSIONS: The present study demonstrated that EA pretreatment may alleviate cardiac ischemia-reperfusion injury in adult patients undergoing heart valve replacements. This simple and convenient treatment has the potential to be used in the clinic for reducing myocardial injury in patients with heart valve replacement surgery."
Souce
Ann Thorac Surg. 2010 Mar;89(3):781-6. doi: 10.1016/j.athoracsur.2009.12.003.
