Effect Of Transcutaneous Electrical Acupoint Stimulation Combined With Lidocaine On Stress Response And Postoperative Complications Of Endotracheal Intubation

Objective In this study,transcutaneous electrical stimulation at acupoints(Neiguan and Quchi)was combined with lidocaine to observe its effects on stress response to endotracheal intubation,extubation choking cough rate,postoperative sore throat(POST)and postoperative nausea and vomiting(PONV).Methods A total of 120 patients who underwent elective subtotal thyroidectomy in our hospital from November 2021 to March 2023 were selected and divided into four groups by random number table: control group(group A),lidocaine group(group B),transcutaneous electrical acupoint stimulation group(group C),and transcutaneous electrical acupoint stimulation combined with lidocaine group(group D).Group A received normal saline intravenously before intubation,group B received lidocaine 1 mg/kg intravenously before intubation,group C received preoperative transcutaneous acupoint(Neiguan and Quchi points)electrical stimulation for 30 min and normal saline intravenously before intubation,and group D received preoperative transcutaneous acupoint(Neiguan and Quchi points)electrical stimulation for 30 min and lidocaine 1 mg/kg intravenously before intubation.The palm is upward,the inner closing point is located 2 cm proximal to the midpoint of the volar transverse wrist crease,between the flexor carpi radialis and palmaris longus tendons;the elbow is bent at a right angle,and the curved cistern point is located at the outer end of the transverse elbow crease.In the acupoint intervention group,special electrodes were pasted at Neiguan and Quchi points,and then connected with a Korean acupoint electrical stimulator,and dense waves(2/100 Hz)were selected for waveforms,with a stimulation intensity of 10 mA and a stimulation time of half an hour.General data such as patient name,height,weight,age,and gender were recorded,and systolic blood pressure,diastolic blood pressure,and heart rate were recorded before intubation(T1),and the highest systolic blood pressure,diastolic blood pressure,and fastest heart rate were recorded within 3 min after intubation(T2).The length of time with tube,dosage of anesthetic drugs,extubation tolerance in postoperative anesthesia recovery room,sore throat score within 24 hours after extubation,nausea and vomiting were recorded.Sore throat was evaluated by digital score(VAS),and the collected data were collated and analyzed.ResultsComparison of general dataThere were no significant differences in general data(age,BMI,gender,Mahalanobis grade,length of intubation,dosage of remifentanil,sufentanil,and propofol)among the four groups(P > 0.05).Comparison of blood pressure and heart rate before and after intubationThere was no significant difference in systolic blood pressure,diastolic blood pressure and heart rate before intubation(T1)among the four groups(P > 0.05).There were significant differences in the highest systolic blood pressure,highest diastolic blood pressure,and fastest heart rate within 3 minutes after intubation(T2)among the four groups(P < 0.05).Systolic blood pressure,diastolic blood pressure,and heart rate decreased after intubation(T2)in groups B,C,and D compared with group A(P <0.05).There was no significant difference between group D and groups B and C(P >0.05).There was also no statistical significance between group B and group C(P >0.05).Comparison of incidence of cough during extubationThe incidence of choking cough was 60%(18/30)in group A,23.3%(7/30)in groups B and C,and 3.3%(1/30)in group D.Compared with group A,the incidence of choking cough in group B,group C and group D was lower(P < 0.05).Compared with group B and group C,the incidence of choking cough in group D was lower(P <0.05).There was no significant difference between group B and group C(P > 0.05).Transcutaneous electrical acupoint stimulation combined with lidocaine group was superior to lidocaine alone or transcutaneous electrical acupoint stimulation alone in reducing the rate of extubation choking cough.Comparison of postoperative sore throat scoresThere were significant differences in sore throat scores among the four groups at extubation(0 h),after extubation(12 h),and after extubation(24 h)(P < 0.05).At just extubation(0 h)and after extubation(12 h),the degree of sore throat was reduced in groups B,C,and D compared with group A(P < 0.05),the degree of sore throat was reduced in groups C and D compared with group B(P < 0.05),and there was no significant change in the effect of sore throat between group C and group D(P > 0.05).After extubation(24 hours),the degree of sore throat was reduced in groups B,C,and D compared with group A(P < 0.05),in groups C and D compared with group B(P <0.05),and in group D compared with group C(P < 0.05).Comparison of PONV within 24 hours after surgeryThe incidence of PONV was 60%(18/30)in group A,66.7%(20/30)in group B,30.0%(9/30)in group C,and 26.7%(8/30)in group D.The incidence of PONV was not statistically significant between group A and group B(P > 0.05).Compared with group D,group C had a similar effect in reducing the incidence of PONV(P > 0.05).However,compared with groups A and B,groups C and D were effective in reducing the incidence of PONV(P < 0.05).Conclusion Transcutaneous electrical acupoint stimulation combined with lidocaine can reduce the stress response after intubation,reduce the incidence of choking cough after extubation,reduce the degree of sore throat within 24 hours after surgery,and reduce the number of nausea and vomiting within 24 hours after surgery.