The influence of perioperative immune function and postoperative nausea and vomiting of different intervention time of general anesthesia acupuncture intervention in the patients with laparoscopic surgery

Abstract

Objective To explore the influence of perioperative immune function and postoperative nausea and vomiting (PONV) of different intervention time of general anesthesia acupuncture intervention in the patients with laparoscopic surgery. Methods According to random number table method, 104 patients with laparoscopic surgery using general anesthesia from October 2015 to December 2016 in our hospital were divided into A, B, C, D group with 26 patients in each group. All patients were treated with tracheal intubation anesthesia. Patients in group A (acupuncture half an hour before anesthesia), group B (acupuncture in the surgery), group C (acupuncture after the end of the surgery) and group D (without acupuncture). The levels of T lymphocyte subsets, including total T lymphocytes (CD3+), T helper cells (CD4+) and T suppressor cell (CD8+), and the CD4+/CD8+, were detected at half an hour before anesthesia induction (T0), the end of surgery (T1), postoperative day 1 (T2) and postoperative day 3 (T3). At the same time, the levels of IgA, IgM and IgG were calculated by suspension method. In addition, the occurrence and score of PONV were observed in postoperative 6h (T4), 12h after surgery (T5) and 48h after surgery (T6). The occurrence of adverse reactions was observed postoperative 1 week. Results The various immune index at T3 CD3+ (62.12% ± 8.37% vs. 58.15% ± 3.92%, 57.15% ± 7.83%, 55.32% ± 7.66%, F=132.238), CD4+ (37.99% ± 6.92% vs. 34.03% ± 6.32%, 34.00% ± 6.49%, 33.85% ± 6.73%, F=2.794), CD8+ (25.07% ± 5.06% vs. 22.89% ± 1.32%, 22.91% ± 1.24%, 22.78% ± 1.75%, F=2.849), CD4+/CD8+ (1.30 ± 0.34 vs. 1.27 ± 0.34, 1.29 ± 0.31, 1.25 ± 0.27, F=5.413), IgA (151.15 ± 36.83 IU/ml vs. 135.24 ± 15.17 IU/ml, 135.16 ± 16.09 IU/ml, 132.05 ± 17.37 IU/ml, F=3.044), IgM (169.35 ± 53.69 IU/ml vs. 146.26 ± 23.06 IU/ml, 145.73 ± 24.66 IU/ml, 143.12 ± 21.43 IU/ml, F=2.839), IgG 131.89 ± 28.13 IU/ml vs. 118.88 ± 15.35 IU/ml, 116.92 ± 20.25 IU/ml, 115.06 ± 20.55 IU/ml, F=3.165)] in the group A were significantly higher than those in the other three groups (P<0.05); Meanwhile the PONV score of patients in group A at T5 (1.76 ± 0.24 vs. 1.98 ± 0.31, 1.96 ± 0.37, 2.09 ± 0.33, F=4.918) were significantly lower than that in the other three groups (P<0.05); the PONV score of patients in group A at T6 (1.33 ± 0.36 vs. 1.52 ± 0.26, 1.54 ± 0.28, 1.73 ± 0.35 , F=6.984) were significantly lower than that in the other three groups (P<0.05); The incidence of adverse events in group A [11.5%(3/26) vs. 38.5% (10/26), χ2=5.026] was lower than that in group D (P<0.05). Conclusions Preoperative acupuncture can effectively improve immunosuppressive state of patients with laparoscopic surgery during general anesthesia perioperative, and reduce the incidence of PONV and PONV score. Key words: Acupuncture; Anesthesia, General; Laparoscopes; Chronomedicine; Perioperative period; Immune function; Postoperative nausea and vomiting