Seventy eligible children were analyzed, 36 in controls and 34 in TEAS group.
Sample Count
70
Age
2月12日
Control
Sham
control group(n=36)
Experiment
TEAS group(n=34)
Indicator
cTnISerum cytokineC-reactive protein(CRP)
Auxiliary Medication
Anesthesia was induced with midazolam, fentanyl, and rocuronium, maintained with a combination of inhaled sevoflurane in oxygen and intravenous anesthetic agents mentioned earlier. Methylprednisolone 30 mgkg-1 was administrated in bypass prime for all cases. All patients first received a basal anesthesia (ketamine 4-6 mgkg-1, im).
Stimulation Method
TEAS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
Hwato, model No.SDZ-V
Suzhou Medical Instruments Co, Ltd, Suzhou, China
2 Hz
disperse-dense wave
14±3 mA
30 min
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
pre-gelled silver–silver chloride electrodes (1.5 cm in diamete)
-
-
Description An electrical acupoint stimulator and disposable transcutaneous,pre-gelled silver–silver chloride electrodes (1.5 cm in diameter) were used (Hwato, model No. SDZ-V; Suzhou Medical Instruments Co, Ltd, Suzhou, China).
The stimulus was a ‘disperse-dense’ wave with frequency of 2 Hz for 30 min. The optimal intensity (mean,14 ± 3 mA) was adjusted to maintain a slight twitching of the midfinger or ring finger, which is a good De-Qi phenomenon indicating that patient with an efficacy to stimulus.
Anesthesia Method
AAA
Clinical Trial Type
random
Contraindications
Exclusion criteria were children with severe pulmonary arterial hypertension, respiratory disease, complicated congenital heart disease, weight <10 kg, or who with isolated atrial septal defect (ASD) treated using a video-assisted thoracoscopic operation
Effector
Seventy eligible children were analyzed, 36 in controls and 34 in TEAS group. Compared with controls, the mean cTnI levels were significantly lower in TEAS group at 8h (P=0.043) and 24h (P=0.046) after aortic unclamping. The duration of ventilation (P=0.004) and length of ICU stay (P=0.032) was significantly longer in controls than in TEAS group. There was a significant difference in the release of C-reactive protein at 8h (P=0.039) between two groups, whereas the values for cytokines were not significant. Transcutaneous electric acupoint stimulation on the bilateral P6 acupoint is effective for attenuation myocardial injury in children undergoing cardiac surgery. The beneficial effects may be partially associated with reduction in cTnI and C-reactive protein level in the early postoperative period.
Cardioprotective effect of transcutaneous electric acupoint stimulation in the pediatric cardiac patients: a randomized controlled clinical trial.
Abstract
BACKGROUND: Acupuncture pretreatment exerts neuroprotective and cardioprotective effects in animal models and in adult patients underwent cardiac surgery; however, data in pediatric patient are unavailable. OBJECTIVE/AIM: To investigate the effects of transcutaneous electric acupoint stimulation (TEAS) on acute myocardial injury from pediatric open-heart surgery. METHODS: Children, aged 2-12 years, with congenital heart defects scheduled for surgical repair were enrolled. They were randomized to TEAS (administrated at bilateral P6 acupoint for 30 min after basal anesthesia) and control (an electrode was placed on the arm without stimulus) groups. The primary end point was serum cardiac troponin I (cTnI) over 24 h after aortic unclamping. Furthermore, clinical outcome and serum cytokine and C-reactive protein concentrations were evaluated. RESULTS: Seventy eligible children were analyzed, 36 in controls and 34 in TEAS group. Compared with controls, the mean cTnI levels were significantly lower in TEAS group at 8 h (P = 0.043) and 24 h (P = 0.046) after aortic unclamping. The duration of ventilation (P = 0.004) and length of ICU stay (P = 0.032) was significantly longer in controls than in TEAS group. There was a significant difference in the release of C-reactive protein at 8 h (P = 0.039) between two groups, whereas the values for cytokines were not significant. CONCLUSION: Transcutaneous electric acupoint stimulation on the bilateral P6 acupoint is effective for attenuation myocardial injury in children undergoing cardiac surgery. The beneficial effects may be partially associated with reduction in cTnI and C-reactive protein level in the early postoperative period."
Souce
Paediatr Anaesth. 2012 Aug;22(8):805-11. doi: 10.1111/j.1460-9592.2012.03822.x. Epub 2012 Mar 2.
