Ninety patients were randomly assigned to one of three groups: Group I (control group) –received placebo EA for 45 minutes before induction of general anaesthesia (GA); Group II –preoperative EA instituted 45 minutes before induction of GA; Group III – 45 minutes of postoperative EA.
Sample Count
90
Age
18-75
Control
Placebo
Group I (control group) –received placebo EA for 45 minutes before induction of general anaesthesia (GA)(n=30)
Experiment
Group II –preoperative EA instituted 45 minutes before induction of GA(n=30;Group III – 45 minutes of postoperative EA(n=30)
Indicator
Total intraoperative usage of alfentanilAmounts of morphine usedVisual analog scale(VAS)
Auxiliary Medication
All patients received an intravenous dose of alfentanil (10μg/kg) one minute before endotracheal intubation, following which a continuous infusion of alfentanil was started at a rate of 10μg/kg/hr and continued till closure of the muscle layer of the abdomen. Additional intermittent doses of alfentanil (2μg/kg) were administered if the systolic blood pressure (SBP) and/or heart rate (HR) had increased by more than 15% above baseline reading. If the SBP and/or HR remained elevated (i.e. more than 15% above baseline) in spite of two consecutive boluses of alfentanil (2μg/kg), the baseline infusion of alfentanil was increased at an increment of 5μg/kg/hr. Intravenous morphine (0.1mg/kg) was given as a bolus dose to all patients immediately after the termination of alfentanil infusion, followed by i.v. 4mg of ondansetron. Patients’ pain was managed in the recovery room by intermittent i.v. morphine 1-2mg every 5 minutes until the pain intensity became tolerable (i.e. VAS ≤3), after which the patients used the PCA device to titrate the morphine administration to meet individual analgesic needs.
Description The frequencies employed were 2Hz at ST36 and PC6, and 100Hz at the skin incision.
Anesthesia Method
GA
Clinical Trial Type
random
Contraindications
Exclusion criteria included: previous history of acupuncture, ASA physical status > II, patients below 18 years or above 75 years, having a body mass index greater than 30, and those patients who were on β-blockers, had a psychiatric history or who had received opioids in the preceding month
Effector
Patients in Group II (0.44 ± 0.15μg/kg/min) received less alfentanil than those in Group III (0.58 ± 0.22μg/kg/min) (p=0.024), but not significantly less than those in Group I (0.51 ± 0.21μg/kg/min) (p=0.472). Postoperative morphine consumption was numerically lower in Group II compared with the other groups; however, the difference was statistically significant only during the period of 6–12 hours between Group II [0.03 (0.05) mg/kg] and Group I [0.10 (0.11) mg/kg] (p=0.015), and Group II and Group III [0.08 (0.10) mg/kg] (p=0.010). The 24-hour cumulative morphine consumption for Group II (0.52 ± 0.19mg/kg) was less than that for either Group I (0.68 ± 0.38mg/kg) or Group III (0.58 ± 0.27mg/kg), but the difference did not reach significance. In conclusion, preoperative EA leads to a reduced intraoperative alfentanil consumption, though this effect may not be specific, and has a morphine sparing effect during the early postoperative period.
Effects of electroacupuncture on intraoperative and postoperative analgesic requirement.
Abstract
Acupuncture has been shown to be effective in experimental and clinical acute pain settings. This study aims to evaluate the effect of preoperative electroacupuncture (EA) on intraoperative and postoperative analgesic (alfentanil and morphine) requirement in patients scheduled for gynaecologic lower abdominal surgery. Ninety patients were randomly assigned to one of three groups: Group I (control group)--received placebo EA for 45 minutes before induction of general anaesthesia (GA); Group II--preoperative EA instituted 45 minutes before induction of GA; Group III--45 minutes of postoperative EA. The Bispectral Index monitor was used intraoperatively to monitor the hypnotic effect of anaesthetic drugs, and alfentanil was titrated to maintain the blood pressure and pulse rate within +/- 15% of basal values. Postoperative pain was managed by intravenous morphine via a patient-controlled analgesia (PCA) device. Patients in Group II (0.44 +/- .15microg/kg/min) received less alfentanil than those in Group III (0.58 +/- .22 microg/kg/min) (p = p.024), but not significantly less than those in Group I 10.51 +/- 0.21 microg/kg/min) (p = 0.472). Postoperative morphine consumption was numerically lower in Group II compared with the other groups; however, the difference was statistically significant only during the period of 6-12 hours between Group II [0.03 (0.05) mg/kg] and Group I [0.10 (0.11) mg/kg] (p = 0.015), and Group II and Group III [0.08 (0.10) mg/kg] (p = 0.010). The 24-hour cumulative morphine consumption for Group II (0.52 +/- .19mg/kg) was less than that for either Group I I0.68 +/- 38mg/kg) or Group III (0.58 +/- .27mg/kg), but the difference did not reach significance. In conclusion, preoperative EA leads to a reduced intraoperative alfentanil consumption, though this effect may not be specific, and has a morphine sparing effect during the early postoperative period."
