Abstract
Objective The study aimed to evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on the stress response during intubation and extubation in patients undergoing video-assisted thoracoscopic surgery (VATS). Methods 122 patients undergoing VATS lobectomy were randomly divided into two groups: the TEAS group (n = 62) and the control group (n = 60). Patients in the TEAS group underwent electroacupuncture stimulation of bilateral Neiguan (PC6), Hegu (L14), Lieque (LU7), and Chize (LU5) acupoints from 30 min before anesthesia to the end of surgery. The patients in the control group did not undergo stimulation. The primary endpoints were the hemodynamic parameters and plasma concentrations of epinephrine, norepinephrine, and cortisol. The secondary endpoints were the consumption of remifentanil and propofol, Ramsay sedation score and arousal time, extubation quality score, and postoperative complications. Results The hemodynamic variables and plasma concentrations of epinephrine, norepinephrine, and cortisol during intubation and extubation were lower in the TEAS group at T1, T3, and T4 compared with the control group. TEAS led to a reduction in the consumption of remifentanil (P < 0.01), as well as a reduction in the incidence of postoperative complications. The extubation quality score was lower (P < 0.01) while the Ramsay sedation score was higher (P < 0.01) in the TEAS group than in the control group. However, the arousal time and consumption of propofol were not significantly different between the two groups. Conclusion TEAS can maintain hemodynamic stability, reduce the stress response during intubation and extubation, improve the quality of anesthesia recovery, and decrease the incidence of postoperative complications in patients undergoing VATS.
Highlights
When the body is stimulated by a certain stress, the excitability of sympathetic nerves increases, and the activity of the hypothalamus-pituitary-adrenal cortex axis increases. is specific defense response is called stress response
Patients were randomly assigned to either the transcutaneous electrical acupoint stimulation (TEAS) group or the control group in a 1 : 1 ratio using a computer-generated random number sequence. e group assignment was sealed in consecutively numbered opaque envelopes. e study was designed as a single-blind study in which random codes and corresponding treatment measures were only known from acupuncture
Only 122 participants (62 in the TEAS group and 60 in the control group) were enrolled in this study (Figure 1). e baseline characteristics and demographic data were similar between both groups (Table 1)
Summary
When the body is stimulated by a certain stress, the excitability of sympathetic nerves increases, and the activity of the hypothalamus-pituitary-adrenal cortex axis increases. is specific defense response is called stress response. When the body is stimulated by a certain stress, the excitability of sympathetic nerves increases, and the activity of the hypothalamus-pituitary-adrenal cortex axis increases. After induction of general anesthesia, tracheal intubation and other related operations can cause the body to produce a strong stress response, hemodynamics can fluctuate sharply, and even adverse events such as malignant arrhythmia can occur [3, 4]. Significant systemic stress responses to pain and airway stimulation can occur during this period, including hypertension, tachycardia, and increased intracranial hypertension. Erefore, inhibiting the strong stress response caused by tracheal intubation and extubation is important to ensure the stability of hemodynamics, avoid the occurrence of related cardiovascular events, and ensure the safety and stability of patients through the operation period Significant systemic stress responses to pain and airway stimulation can occur during this period, including hypertension, tachycardia, and increased intracranial hypertension. is induces respiratory reactions, such as breath-holding, restlessness, choking, and bronchospasm [5, 6]. erefore, inhibiting the strong stress response caused by tracheal intubation and extubation is important to ensure the stability of hemodynamics, avoid the occurrence of related cardiovascular events, and ensure the safety and stability of patients through the operation period
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