Effect Of Transcutaneous Electrical Acupoint Stimulation On Oxidative Stress And Lung Function During One-lung Ventilation

Objective:To observe the effect of transcutaneous electrical acupoint stimulation（TEAS）on oxidative stress,lung function,and postoperative recovery quality during one-lung ventilation in patients undergoing thoracoscopic surgery.Methods:Eighty patients were recruited for thoracoscopic lobectomy in the present study.The patients were randomly assigned to the TEAS group（group T）or control group（group C）.The patients in group T received TEAS on bilateral Feishu（BL13）,Hegu（L14）,and Zusanli（ST36）from 30 minutes before induction of anesthesia to the end of the operation.The TEAS was maintained at a frequency of 2/100 Hz using a dilatational wave throughout the procedure.Adjust the optimal strength according to the individual’s maximum tolerance.The patients in group C was connected to the electrode on the same acupoints but did not receive stimulation.The values of MAP and HR were recorded before one-lung ventilation（T₀）,30 minutes after one-lung ventilation（T₁）,1 hour after one-lung ventilation（T₂）,and 10 minutes after resuming two-lung ventilation（T₃）.Radial artery blood samples were collected from T₀ to T₃ for blood gas analysis.Pa O₂/Fi O₂,alveolar-arterial oxygen tension（A-a DO₂）,respiratory index（RI）,and intrapulmonary shunt ratio（Qs/Qt）were calculated according to the formula.The levels of malondialdehyde（MDA）and superoxide dismutase（SOD）were detected by collecting venous blood to estimate oxidative stress from T₀ to T₃.In addition,secondary outcomes included the incidence of postoperative pulmonary complications,removal time of thoracic drainage tube,duration of SICU stay,length of postoperative hospitalization,and the Quality of Recovery-15（Qo R-15）score on postoperative day 1 and 2.Results:1 There were no differences in demographic data between the two groups（P>0.05）.2 Comparison of intraoperative hemodynamics,blood gas,and lung function between the two groups:There were no significant differences in HR,MAP,pH,Hb and Pa CO₂ between the two groups（P>0.05）.Compared with T₀,the levels of Pa O₂/Fi O₂ in both groups were obviously decreased at T₁,T₂ and T₃,while A-a DO₂,RI and Qs/Qt were significantly increased（P<0.05）.TEAS significantly increased Pa O₂/Fi O₂ at T₁ and T₂ than that in the control group.At T₁,T₂,and T₃,A-a DO₂,RI and Qs/Qt in TEAS group were remarkably lower than those in the control group（P<0.05）.3 The serum MDA content and SOD activity were compared between the two groups:No significant differences were identified in MDA content and SOD activity between the two groups at T₀ and T₁（P>0.05）.The level of MDA increased at T₁,T₂,and T₃ in both groups compared with T₀（P<0.05）.Compared with T₀,the level of SOD in both groups significantly decreased at T₂ and T₃（P<0.05）.Meanwhile,at T₂ and T₃,the content of serum MDA was significantly lower in group TEAS than that in the control group,whereas SOD activity of the TEAS group was markedly increased（P<0.05）.4 The incidence of postoperative pulmonary complications and other clinical indicators between the both groups:No significant differences were identified in the incidence of pleural effusion,pulmonary atelectasis,and the removal time of the thoracic drainage tube between both groups（P>0.05）.However,compared with the control group,the duration of ICU stay and hospital stay after surgery were significantly shortened in the TEAS group（P<0.05）.Moreover,the Qo R-15 score at postoperative day1 and 2 was obviously higher in group TEAS compared with the control group（P<0.05）.Conclusions:TEAS can reduce oxidative lung injury during one-lung ventilation,thereby protecting pulmonary function and effectively accelerating the early recovery of patients.