Effect of transcutaneous electrical acupoint stimulation combined with general anesthesia on intraoperative and postoperative recovery in patients undergoing carotid artery stenting

Abstract

Objective To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) combined with general anesthesia on intraoperative medication and postoperative recovery in patients undergoing carotid artery stenting (CAS). Methods Eighty-two patients with CAS under general anesthesia were randomly divided into the transcutaneous electrical acupoint stimulation combined with general anesthesia group (group T, n=40) and the traditional general anesthesia control group (group C, n=42). The surgical side acupoints of the body for acupuncture were selected as, Shuigou and Baihui, Hegu and Waiguan. For patients in group T, the electrodes were pateched pasted at the corresponding locations and were stimulated by HANS. For the patients in group C, the electrodes were placed at the same location but not stimulated by HANS. The blood pressure and heart rate are maintained within in the (1±20)% range of the baseline. The hemodynamic changes during the operation, the use of vasoactive drugs and the postoperative recovery of the patients were recorded. Results After 30 min of the transcutaneous electrical acupoint stimulation, the blood pressure in the group T was lower than the level of baseline (P 0.05). At 5 min before extubation and 5 min after extubation, the heart rate of patients in group T was lower than that of patients in group C (P 0.05). There was no statistical difference in among the number of cases and total amount of dopamine, atropine and urapidil in the two groups (P>0.05). The amount of remifentanil used in group T was less than that in group C (P 0.05). The time of respiration recovery, wake-up time and extubation time in the group T were less than those in group C (P 0.05). The numbers of patients with postoperative moderate pain (VAS score more than 4 points above) were analyzed at 9 am and 4 pm at one day after the operation. The incidence of postoperative moderate pain in group T was significantly lower than the incidence in group C (P<0.05). Conclusions TEAS combined with general anesthesia for CAS surgery can stabilize hemodynamics changes, reduce analgesic remifentanil consumption, shorten the wake-up time and extubation time after surgery, reduce the incidence of postoperative pain, and improve the patients′ satisfaction with anesthesia. Key words: Transcutaneous electrical acupoint stimulation; Carotid artery stenting; Anesthesia, general; Postoperative recovery