Effects Of Electroacupuncture On Stress Response And Postoperative Agitation In Patients Undergoing Modified Radical Mastectomy For Breast Cancer

Background: For the past few years,the incidence rate of breast cancer in our country has remained high,occupying the first place of female malignant tumors,and there is a gradual trend towards youth.This is a comprehensive consequence of multiple factors,and its mechanism has not been fully clarified.The current mode of diagnosis and treatment is mainly comprehensive therapy,and surgery occupies the main position.Among them,modified radical mastectomy is one of the most common surgical methods.Therefore,this study mainly focused on the perioperative stress response and postoperative agitation in patients undergoing modified radical mastectomy for breast cancer.Stress response is a series of non-specific systemic responses initiated to protect the body’s homeostasis.Anesthesia operations,drug application,surgical trauma,and postoperative pain will all bring strong stress responses to the body.A certain degree of stress is conducive to mobilizing the body’s adaptability and tolerance to trauma,while excessive and prolonged stress may lead to physiological dysfunction of the body,and even lead to pathological changes,and postoperative complications will also follow.Among them,restlessness during recovery is one of the common postoperative complications in patients undergoing general anesthesia surgery.Pain stimulation and surgical stress are the main triggering factors.If not treated in time,it may even endanger the life safety of patients.With the multi-modal development of comfort care,anesthesiologists have made in-depth research in finding ways to reduce perioperative stress and reduce the incidence of postoperative agitation,but these methods are often accompanied by different degrees of complications.Therefore,it is the focus of our anesthesiologists to find an anesthesia method that is convenient and simple to operate,has little impact on the body,and can well reduce stress response and postoperative agitation.Electro-acupuncture is widely used in clinical anesthesia.It is developed on the basis of acupuncture and moxibustion.The needles are stimulated with micro-currents to stimulate the relevant acupoints in the body,resulting in the effects of analgesia and protection of important organs of the body.Under general anesthesia,supplemented with electroacupuncture preconditioning is a new type of anesthesia.At present,there are relatively few studies on the effects of electroacupuncture on the stress response and postoperative agitation in patients undergoing modified radical mastectomy for breast cancer.Therefore,the purpose of this study was to investigate how electroacupuncture stimulated the relevant acupoints in patients with the regulation of neuroendocrine responses(epinephrine,norepinephrine),acute phase responses(C-reactive protein)and immune system responses(IL-6)in the stress response.And to evaluate whether it can reduce the incidence of postoperative agitation in patients.Purpose: Through electro-acupuncture pretreatment,the changes of perioperative stress response level and its effect on postoperative agitation in patients were observed.Methods: According to the inclusion and exclusion criteria,there were 64 patients in total with surgery who underwent modified radical mastectomy for breast cancer in Nanyang First People’s Hospital between November 2020 and June 2021 were selected.The patients were divided into electroacupuncture stimulation group(group D)and sham-electroacupuncture stimulation group(group M)by random number table method.Both groups were treated with intravenous inhalation compound anesthesia,and group D used an electroacupuncture therapeutic apparatus(model: G6805-IIB,frequency 2/100 Hz sparse-dense wave,current 1 m A)to stimulate bilateral Neiguan and Hegu acupoints for 30 minutes before anesthesia induction,and then connected to normal saline placebo analgesia pump after operation;group M was the same as group D before induction of anesthesia,but no electric current was connected,postoperative analgesia using sufentanil with analgesia pump,continuous intravenous infusion of analgesia.The changes in HR and MAP were recorded at 5 minutes after entering the chamber(TA1),after electroacupuncture stimulation(TA2),during endotracheal intubation(TA3),skin incision(TA4),and endotracheal tube removal(TA5).Blood was drawn from the vein at five time points: 5 minutes after entering the room(TB1),after electroacupuncture stimulation(TB2),endotracheal tube removal(TB3),2 hours after surgery(TB4),and 24 hours after surgery(TB5),the contents of CRP,IL-6,E and NE in the blood samples of the two groups of patients were determined.Collect the VAS scores of the groups at the time of endotracheal tube removal(TB3),2 hours after operation(TB4),and 24 hours after operation(TB5).The Ramsay sedation score during the recovery period and the occurrence of postoperative adverse reactions were recorded in the two groups.Results: There were 60 patients in total were enrolled and the collected data were analyzed.Results representation:1.Comparison of hemodynamic changes: There was no statistically significant difference in the baseline values of MAP and HR between the two groups of patients D and M after stable admission(P>0.05);compared with TA1,there was no statistical difference in the changes of MAP and HR between the two groups at TA2(P>0.05),MAP and HR increased at TA3,TA4 and TA5,with statistical difference(P<0.05);compared with group M,the increase in group D was smaller,with statistical difference(P<0.05).2.Comparison of changes in stress indicators: there was no statistical difference in the initial values of stress indicators between the two groups of patients D and M(P>0.05);compared with TB1,there was no statistical difference in the changes of stress indicators between the two groups at the time of TB2(P>0.05),and increased at the time of TB3,TB4 and TB5,with statistical difference(P<0.05);compared with group M,the increase of stress indicators in group D was smaller,with statistical difference(P<0.05).3.Comparison of VAS scores: There was no significant difference between the two groups at TB3,TB4 and TB5(P>0.05).4.Ramsay sedation score comparison: group D was lower than group M,with statistical difference(P<0.05).5.Comparison of postoperative complications: The incidence of postoperative adverse reactions in group D was less than that in group M,and there was a statistical difference(P<0.05).Conclusion: The results of this study show that for patients undergoing modified radical mastectomy for breast cancer,under combined intravenous inhalation anesthesia,electroacupuncture preconditioning at Neiguan and Hegu points can maintain the stability of the cardiovascular system,relieve postoperative pain,reduce perioperative stress response,and effectively reduce the incidence of agitation during postoperative recovery.