| Objective:(1) To investigate the vision-related quality of life (VRQoL) of patients with rhegmatogenous retinal detachment (RRD) before and after relative surgery, and analyze the influencing factors. (2) To Study the analgesic effects and related mechanisms of transcutaneous electrical acupoint stimulation (TEAS) in scleral buckles, thus to optimize analgesia methods by the means of TCM, to alleviate pains in patients during and after surgery,as well as to improve their quality of life.Methods(1) A scale table of life quality for patients with visual impair-ment (AQoL-DVI) has been Introduced to 92 RRD patients preoperatively, and at the end of the follow-uptime. (2) 40 cases of RRD patients were randomly divided into two groups:the Partial anesthesia group and the complex anesthesia group. Anesthesia was used to both groups by 2% lidocaine 3ml and ropivacaine 0.894% 3ml in retrobulbar and the orbicularis muscles. In contrast, the TEAS with Hans instrument were untilized to the complex anesthesia group, along the side Hegu and neiguan point during surgery. ECG monitoring was used. And the Short-form of McGill pain questionnaire (SF-MPQ) was adopted to assess degree of pain VAS after surgery.2ml venous blood before surgery and after surgery were used to detect of plasmaβ-endorphin(β-EP) and cholecystokinin 8 peptide (CCK-8) contents with Enzyme-linked immunosorbent assay,and the statistical software SPSS 13.0 was used to analyze the data.Results:(1) The lowest scores before the surgery concentrated on the item of "social life", while, after operation,the significantly increased scores also concentrated on the same item.It is shown that the chief independent factor affects questionnaire scores are the change of visual acuity after surgery. (2) The VAS pain intensity scores were lower in the complex anesthesia group than in Partial anesthesia group (P<0.05); and the total scores of the emotion and feeling items were lower too in complex anesthesia group than the partial anesthesia group (P<0.05). Anesthetic dosage was lower in the complex anesthesia group than in partial anesthesia group, (P<0.05). Intraoperative heart rate fluctuations in the complex anesthesia group were lower than in partial anesthesia group (P<0.05).The positive rate of OCR was lower in the complex anesthesia group than in the partial anesthesia group, there was no significant difference of the levels of plasmaβ-EP between the two groups (P> 0.05) before or after surgery, only the plasmaβ-EP of the Complex anesthesia group after operation increased comparatively (P<0.05). After operation, CCK-8 concentration increased both in the partial anesthesia group and the complex anesthesia group (P<0.05). But between the two groups, the statics of the CCK-8 concentration before and after surgery sugest no significant difference (P> 0.05).Conclusion:(1) As VRQoL data, especially that of "social life", show that, the qualities of life of patients sampled in this reaserach decreased sharply with RRD, and had been improves obviously to some extend after operations, but the patient would not be convenient for doing some Precise daily work. Improving the visual acuity of the RRD eye, giving timely surgery and avoiding complications would significantly improve the VRQoL of the patients with RRD.(2) TEAS assisted Partial anesthesia in retinal detachment surgery has a good analgesic effect., and it is better than Partial anesthesia treatment alone, It shall reduce the amount of intraoperative anesthetic, reduce the incidence of OCR. The mechanism may be tha theβ-EP could be release easily through TEAS incorporated with Partial anesthesia,thus the compound anesthesia works better,and in some emergent cases, the body will increase the release of CCK-8. However, due to the less amount of samples, and large individual differences, the release of CCK-8 by TEAS had not been observed, and that demands our more efforts and hard works in the near future.
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