Preliminary Study On Sedative Effect Of Electroacupuncture On Patients After Valve Replacement

Backgrounds and objectives:We usually adopt sedative drugs, such as midazolam and propofol,to calm mechanically ventilated patients in the intensive care unit(ICU).A great deal of documents published was showed the sedative effect of acupuncture on patients who had insomnia or anxious disease.Few reports about the sedative effect of acupuncture was reported on mechanically ventilated patients in the ICU.The aim of this study was to:(1)investigate the sedative effect of acupuncture on patient during mechanical ventilation after valve replacements.(2)assess the correlation between bispectral index(BIS)and Rmasay score.(3)observe if acupuncture can reduce the adverse reaction of propofol which was used in patients during mechanical ventilation after valve replacements. (4)evaluate whether acupuncture has influence in pulmonary shunt fraction(Qs/Qt)and oxygen metabolism on patients who used propofol after valve replacement.Methods:Sixty patients during mechanical ventilation after valve replacement were randomly assigned to three groups.Intravenous injection of propofol was given to patients in groupâ… ;to patients in groupâ…¡,propofol was given also and acupuncture at Shenting and Yintang with needle retention was applied simultaneously;and to those in groupâ…¢,the same treatment as that for groupâ…¡was applied but with electro acupunture instead of simple acupuncture.The speed of propofol was controlled through micro-pump to maintain the BIS within 70-80.The dose of propofol used,the Ramsay score,adverse reaction, and blood sugar(GLU)and so on in the three groups were observed and compared.Arterial and mixed venous blood gases were analyzed before intravenous injection of propofol and 2.5h after propofol was given. The pulmonary shunt fraction(Qs/Qt)and oxygen extraction rate(ERO₂) were calculated.The respiratory rate(RR),Qs/Qt,and ERO₂,and so on before and after sedation in the three groups were observed and compared.Results:The dose of propofol used per hour was(1.36±0.42)mg/kg in groupâ… ,which was(1.51±0.42)mg/kg in groupâ…¡,and which was (0.99±0.22)mg/kg in groupâ…¢.Propofol dose used was insignificantly different between groupâ… and groupâ…¡(P＞0.05),but in groupâ…¢which was more reduced than that in the other two groups(P＜0.05).No significant difference in BIS,Ramsay score,adverse reaction,GLU, etc.was found among the three groups.BIS measurements showed negative correlation with Ramsay scores(γ=-0.85,P＜0.01).No significant difference in BIS,RR,Qs/Qt,ERO₂,and S(?)O₂ was found among the three groups not only before sedation but also after sedation (P＞0.05).Compared to before intravenous injection of propofol,2.5h after propofol was given BIS,RR and ERO₂ were found obvious decline (P＜0.05),S(?)O₂ was found obvious increase(P＜0.05),no significant difference was found in Qs/Qt(P＞0.05).CoNclusion:(1)Electro acupuncture at Shenting and Yintang has a certain sedative effect on patients during mechanical ventilation after valve replacement.(2)BIS measurements were favorably correlated with Ramsay scores.BIS is an objective tool with good reliabilities for sedation evaluation.BIS could be used to evaluate levels of sedation on patient during mechanical ventilation in ICU. (3)Acupuncture had not show which could reduce the adverse reaction of propofol which was used in patients during mechanical ventilation after valve replacements.(4)Acupuncture at Shenting and Yintang had no influence in GLU on patients who used propofol after valve replacement.(5)After sedation,RR and ERO₂ were found obvious decline, S(?)O₂ was found obvious increase,no significant difference was found in Qs/Qt.(6)Acupuncture at Shenting and Yintang exercised no influence in Qs/Qt and oxygen metabolism on patients who used propofol after valve replacement.