The Clinical Application Of Percutaneous Acupoint Electrical Stimulation In The Internal Acupoints Of Sanli Points In The Treatment Of Supraorbital Mucosal Circumcision

Transcutaneous electrical acupoint stimulation ?TEAS? is one of the hotspots of acupuncture anesthesia in the field of modern anesthesia. Its purpose is to reduce the incidence of anesthesia and perioperative complications and adverse reactions. At present, TEAS's functions are known mainly in the following aspects:1. To reduce the amount of anesthetic;2. To protect organ function, prevent reperfusion injury;3. Promote anesthesia awakening, reduce the incidence of postoperative cognitive dysfunction ?POCD?;4. Assisted postoperative pain treatment;5 To reduce postoperative nausea, vomiting, urinary retention and other complications;6. To eliminate perioperative anxiety, relieve tensions in patients.At present, Procedure for Prolapsed and Hemorrhoids ?PPH? is the main method of the treatment of mixed hemorrhoids and rectal prolapse. In the intraoperative, when stapler fired instantly, patients often suffered lower abdominal pain, decreased heart rate and other stretch reflex, caused by pull the rectum mucosa. When there is stretch reflex, the anesthesiologist will be intravenous administration of symptomatic treatment. Sometimes, they also oppressed patients with Neiguan acupoint to relieve symptoms. Based on the above reasons, TEAS has been used to observe the clinical effect of PPH in restraining stretch reflex.ObjectiveTo observe Transcutaneous Electrical Acupoint Stimulation?TEAS? at Neiguan and Zusanli acupoint and the effect of the reduction of stress reflex caused by Procedure for Prolapsed and Hemorrhoids ?PPH? operation under Spinal Anaesthesia.Methods130 Patients ?ASA ?-?? with mixed hemorrhoid which were going to accept the operations of PPH,were randomly divided into three groups:the Fentanyl group ?group F n=42? and the TEAS group ?group A n=44? and the Spinal Anaesthesia group ?group S n=44?. Patients in Group F was given intravenous injection of Fentanyl 50ug 5 minutes before Spinal Anaesthesia. Patients in Group A were electro-acupunctured Neiguan and Zusanli acupoint of right side from beginning to the end of the procedure. Patients in Group S were spinal anesthesia group?Control group?.The patient's Heart rate, Systolic blood pressure ?SBP? and Diastolic blood pressure ?DBP? were observed at 5 time points:before anesthesia ?To?, after anesthesia ?T₁?, firing the stapler immediately ?T₂?,5 minutes after firing ?T₃?,10 minute after firing ?T₄?. The Visual Analog Scale ?VAS? of abdominal Traction pain induced by rectal mucosa was recorded at T₂, T₃, T₄ time points. The gastrointestinal adverse reactions such as nausea and vomiting was Observed.ResultsThere was no significant difference in SBP and DBP within groups and between groups at each time point. Group F and group A can reduce the decline of Heart Rate and reduce the Traction pain at time points of T₂, T₃. There was no significant difference in the incidence of traction pain and severe traction pain during the operation in three groups.The incidence of nausea in group A was lower than that in group F and S, which was statistically significant compared with group F. ?P<0.05?Conclusion1.Transcutaneous Electrical Acupoint Stimulation?TEAS? at Neiguan and Zusanli can relieve vagal reflex and abdominal pain caused by traction of hemorrhoid mucosa in PPH with spinal anesthesia, and the effect is similar to that of fentanyl. The incidence of nausea can be reduced.2. Transcutaneous Electrical Acupoint Stimulation?TEAS? at Neiguan and Zusanli still can not inhibit the occurrence of vagal reflex and traction pain in PPH.