Effect Of Transcutaneous Electrical Acupoint Stimulation On Perioperative Respiratory Function In Patients Undergoing Thoracoscopic Lobectomy

Objective To observe the effect of transcutaneous electrical acupoint stimulation at bilateral BL13（Feishu）and LU1（Zhongfu）on perioperative respiratory function in patients undergoing thoracoscopic lobectomy.Methods Sixty-three patients（aged 18-65 years,body mass index（BMI）18.5-24.9 kg/m²,ASA grade II-III,preoperative pulmonary function tests showed no significant abnormalities）undergoing elective thoracoscopic lobectomy under general anesthesia in the Department of General Thoracic Surgery,Ningxia Medical University General Hospital were selected.The patients were divided into 3 groups:control group（group C）,transcutaneous electrical acupoint stimulation group（group D）and transcutaneous electrical non-acupoint stimulation group（group E）by random number table.Group C:No electrical stimulation operation.Group D:After induction of anesthesia,bilateral BL13 and LU1 acupoints were taken for transcutaneous electrical acupoint stimulation,and the stimulation parameters were set as follows:frequency:2/100 Hz,dense waves were selected for waveforms,and the current intensity was set at 12 m A.The intraoperative electrical stimulation mode and intensity remained unchanged until the stimulation was stopped after the end of surgery.Group E:The same stimulation method was performed as group D,but the stimulation site was 2 cm beside BL13 and LU1 acupoints.Arterial partial pressure of oxygen（Pa O₂）,arterial partial pressure of carbon dioxide（Pa CO₂）,oxygenation index（OI）,alveolar-arterial differences for Oxygen（A-a DO₂）,intrapulmonary shunt rate（Qs/Qt）,and respiratory index（RI）were observed and recorded at five time points:before induction of anesthesia（T₀）,10 min after two-lung ventilation（T₁）,30 min after one-lung ventilation（T₂）,1 h after one-lung ventilation（T₃）,and 20 min after resumption of two-lung ventilation（T₄）in the three groups,and heart rate（HR）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,and mean arterial pressure（MAP）were recorded at the above five time points.Results A total of 63 patients completed the study.Intra-group comparison:Pa O₂ in the three groups was higher at T₁-T₄time point than T₀,and the difference was statistically significant（P<0.05）,but the increase was the smallest at T₂time point.The OI of patients in the three groups was higher at T₁time point than T₀,lower at T₂-T₄time point than T₀and lowest at T₂time point,and the difference was statistically significant（P<0.05）.A-a DO₂,Qs/Qt,and RI in the three groups were higher at T₂-T₄time points than at T₀and increased most significantly at T₂time points,and the differences were statistically significant（P<0.05）.Comparison between groups:There were no significant differences in Pa O₂,OI,A-a DO₂,Qs/Qt and RI between group E and group C at each time point（P>0.05）.Pa O₂and OI of patients in group D were higher than those in groups E and C at T₂-T₄time points,and the difference was statistically significant（P<0.05）.A-a DO₂and Qs/Qt of patients in group D were lower than those in groups E and C at T₂-T₄time points,and the difference was statistically significant（P<0.05）.RI in group D was lower than that in groups E and C at T₂-T₄,and there was a significant difference at T₂（P<0.05）,and at T₃,there was a significant difference between groups D and E（P<0.05）.There was no significant difference in the incidence rate of pulmonary complications within three days after operation among the three groups（P>0.05）.Conclusion Transcutaneous electrical acupoint stimulation at bilateral BL13 and LU1 can improve perioperative respiratory function in patients undergoing thoracoscopic lobectomy by improving oxygenation and reducing intrapulmonary shunting,but it has no obvious advantage in reducing the incidence of pulmonary complications within three days after surgery.