Effect Of Transcutaneous Electrical Acupoint Stimulation On Postoperative Analgesia Of Patients Received Ureteroscopic Lithotripsy

Objective Transcutaneous acupoint electrical stimulation（TEAS）is a kind of clinical treatment,which combines traditional Chinese medicine acupoint therapy with electrical stimulation.In this present study,we observed the analgesic effect of TEAS by applying it alone for patients received ureteroscopic holmium laser lithotripsy.Methods Participants（n=120）scheduled for ureteroscopic holmium laser lithotripsy,from November 2017 to June 2018,aged 51⁷3 year-old,with American Society of Anesthesiologists（ASA）status of I or II,in our hospital were enrolled in our study.Participants were divided into the observation group（n=60）and the control group（n=60）by using the method of random number table.The participants in the observation group were treated with TEAS for postoperative analgesia.TEAS was implemented on bilateral Shenshu（BL23）and Yinlingquan（SP9）at the time back ward and the time at 4h,8h,12h postoperatively.The frequency of stimulation was set at low frequency of 2Hz/100Hz and high frequency of 100Hz.The stimulation duration was 30 min for one times and the stimulation intensity was set between 15²5mA.TEAS was re-implemented three times（7a.m.,11 a.m.,15 p.m.）on the target acupoints on the next two days.When TEAS failed to meet the analgesic effect（Visual analogue scale,VAS>3）,the participants were given tramadol hydrochloride tablets of 100mg for remedy analgesia.Participants in the control group were given tramadol hydrochloride tablets for postoperative analgesia,twice daily,100mg per time.Electrode tabs were also attached on bilateral BL23 and SP9 just as participants in the observation group,but electrical stimulation was not implemented.The VAS scores at the time back ward（T₀）,4h（T₁）,12h（T₂）,24h（T₃）,48h（T₄）postoperatively were recorded.The peripheral blood of 5mL was taken for testing the plasma concentration levels of algogenic substance[5-hydroxytryptamine（5-HT）and substance P（SP）]at T₀,T₁,T₂,T₃,T₄ respectively.The amount of remedy analgesics consumption at the first and second 24h postoperatively and the total consumption of remedy analgesics within 48h postoperatively were also recorded.The postoperative adverse reactions,such as nausea and vomiting,were also documented.Results 1 The baseline characteristic of age,sex,weight,operation time,etc,were similar among two groups.2 Compared to T₀,the VAS scores at T₁,T₂,T₃,T₄ of two groups were lower（P<0.05）.Compared to the control group,the VAS scores at T₁,T₂ and T₃ in the observation group were lower（P<0.05）.Statistical differences were not existed at T₄ between groups（P>0.05）.3 Compared with the first 24h after operation,the consumption of remedial analgesics in the second 24h was lower in both groups（P<0.05）.Compared to the control group,the consumption of remedy analgesics at the first and second 24 h and the total consumption of remedy analgesics within 48h postoperatively in the observation group were significant lower（P<0.05）.4 Compared to T₀,the plasma concentration levels of 5-HT and SP in the observation group were lower at T₁,T₂,T₃,T₄（P<0.05）.While in the control group,the plasma concentration level of 5-HT at T₄ and the plasma concentration levels of SP at T₂,T₃,T₄ were lower than T₀（P<0.05）.Compared with the control group,the plasma concentration levels of 5-HT at T₁,T₂ and T₄ in the observation group were lower（P<0.05）,while the plasma concentration levels of SP at T₁,T₂,T₃ and T₄ were lower（P<0.05）.5 The incidence of constipation,nausea and vomiting in the observation group was also lower than that in the control group（P<0.05）,but there was no significant difference in the incidence of skin itching,sleepiness,urinary retention,etc,between the two groups（P>0.05）.Conclusion The study demonstrated that TEAS can effectively alleviate the postoperative pain intensity,reduce the consumption of postoperative analgesic drugs,decrease the plasma concentration of algogenic substance（5-HT and SP）,and reduce the incidence of postoperative adverse reactions after ureteroscopic holmium laser lithotripsy.Figure 8;Table 5;Reference 46.