Effects Of Transcutaneous Electrical Acupoint Stimulation On Postoperative Agitation In Children Undergoing An Adenotonsillectomy

Objective To investigate the Effects of Transcutaneous Electrical AcupointStimulation(TEAS) combined with general anesthesia on postoperative agitation andhemodynamics in children undergoing an adenotonsillectomy and tonsillectomy.Methods Sixty patients with ASA I-II scheduled for undergoing anadenotonsillectomy and tonsillectomy were randomly assigned to the following twogroups: TEAS(group T, n=30)and controlled (group C, n=30). Group T receivedcontinuous TEAS at points hegu and neiguan30min before anesthesia induction till theend of operation. In both groups, anesthesia was induced with midazolam, fentanyl,propofol, atracurium and maintained with remifentanyil, propofol and atracurium. If thepatient emergence inconsolable after operation, infusion fentanyl0.5-1μg/kg wasadministered. The heart rate(HR), saturation of pulse oxygen(SpO2), mean arterial bloodpressure(MAP), bispectral index(BIS) were monitored during and after operation. Thetime of the anesthesia and operation, The time in PACU, Postoperative nausea andvomiting (PONV), the dosage of the propofol and remifentanyil were recorded.Observed changes of plasma level of Beta-endorphin β-EP),epinephrine (E),norepinephrine(NE) and cortisol(COR). Agitation(evaluate by pediatric anesthesiaemergence delirium, PAED) Scale and analgesia(evaluated by faces painscale-revised,FPS-R) was assessed just after tracheal extubation,5minutes,10minutes,15minutes and30minutes later after tracheal extubation. Finally, statisticalanalysis was performed using SPSS version13.0. Results are reported as mean± standard deviation for measurement data fitting the normal distribution. The statisticalsignificance of differences between groups was analyzed using the one-way analysis ofvariance (ANOVA) and groups were compared using a repeated measures designanalysis of variance. PAED score and FPS-R of score to the median score werecompared using the Mann–Whitney U-test.Results Two groups of patients’ gender, age, weight, anesthesia time, operative timedifferences were not statistically significant (P>0.05). Group C in the postoperativeanesthesia recovery unit (PACU) time, nausea and vomiting incidence, the dose ofpropofol and remifentanil were higher than group A. Bispectral index decreasedsignificantly at T group after electrical stimulation30min (P <0.01). Compared with thatof at baseline, plasma levels of E, NE and COR increased significantly after intubation,after extubation and10minutes (P<0.05). Levels of plasma NE, E and COR of groupC was significantly higher than those of group T (P <0.05). Levels of plasma beta-EPafter electrical stimulation30min of group T was significantly higher than those ofgroup C (P <0.05). Compared with that of group T, plasma levels of beta-EP in groupC of after intubation, after extubation and10minutes increased significantly (P<0.05).The HR and MAP in group C were higher than those in group T at different time pointsafter tracheal extubation (P<0.05). The PAED Scale and the FPS-R in group T was bothlower than in group C at different time points after tracheal extubation (P<0.05).Conclusion Transcutaneous Electrical Acupoint Stimulation can bebeneficial for reducing postoperative agitation and hemodynamic changes in childrenundergoing adenotonsillectomy.