The Study Of The Value-based Anesthesia Of Transcutaneous Acupoint Electrical Stimulation(TAES) Supplement With General Intravenous Anesthesia

Objective:To explore the value-based anesthesia of transcutaneous acupoint electrical stimulation(TAES) supplement with general intravenous anesthesia in subtotal thyroidectomy surgery.Methods:Sixty patients(ASAⅠ～Ⅱ) undergoing subtotal thyroidectomy surgery were randomly divided into two groups with 30 patients in each group:treatment group,TAES supplement with general intravenous anesthesia and control group,total intravenous anesthesia. Before induction of anesthesia,treatment group was stimulated at hibateral Hegu and Neiguan acupoint for 20min by Han's Acupoint Nerve Stimulator(HANS) and control group was reposed for 20min in operating room.Then anesthesia was induced with midazolam 0.05mg/kg,fentanyl 2ug/kg,Vecuronium 0.1mg/kg,propofol 1-2mg/kg.Treatment group was sustaining electrical stimulated at hibateral Hegu and Neiguan acupoint until extubation.The pumping speed of propofol and remifentanil was adjusted according to hemodynamic changes and the BIS value. The BIS value,HR,SBP,DBP and MAP were monitored continuously in the perioperative period.The concentrations of epinephrine and norepinrphrine were measured after entering the operating room,before induction of anesthesia,intubation,maximum operative trauma,the end of surgery.The time from the end of surgery to extubation and leave the operating room were recorded.We also recorded the total dosage of vecuronium,propofol and remifentanil and their costs,the side effects after surgery and satisfaction degree with anesthesia of patients.Results: Compared with baseline values,there were significant decrease in the BIS value,HR,SBP,DBP and MAP in treatment group before induction of anesthesia(P＜0.01).The BIS value,HR and MAP in treatment group were lower significantly than those in control group before induction of anesthesia(P＜0.05).The hemodynamics in treatment group was more stable than control group during surgery(P＜0.05).The concentration of epinephrine and norepinrphrine during surgery in control group were higher than baseline values(P＜0.05) and compared with the same time points of treatment group,there were significant difference(P＜0.01).The time from the end of surgery to extubation and leaving the operating room were shorter significantly in treatment group than that in control grouop(P＜0.01).The total dosage and costs of propofol and remifentanil in treatment group were significant decrease compared with that in control group (P＜0.05).The side effects after surgery and the degree of satisfaction with anesthesia of two groups were no significant difference.Conclusion:TAES supplement with general intravenous anesthesia can maintain the hemodynamics more stable and depress the stress response for subtotal thyroidectomy surgery.Meanwhile,it can shorten the time of leaving the operating room and reduce the total dosage of anesthetic and the cost of anaesthesia.