Effects Of Transcutaneous Electric Acupoint Stimulation On Perioperative High-Sensitive Cardiac Troponin T And Heart Rate Variability Of Elderly Patients With Coronary Heart Disease

Objective: To observe the effects of transcutaneous electric acupoint stimulation on perioperative high-sensitive cardiac troponin T and heart rate variability of elderly patients with coronary heart disease.Methods: Fifty patients with coronary heart disease of both sexes,ASA Ⅱ/Ⅲ,aged 65-80 yrs,scheduled for elective lumbar decompression and fusion internal fixation surgery,were randomly divided into 2 groups(n=25 each)by random number table: control group(group C)and TAES group(group T).Patients in group T received TEAS of disperse-dense waves(frequency: 4/20Hz)on acupoints of PC6(Neiguan)and PC4(Ximen)from 30 min before anesthesia induction to the end of surgery,the optimal intensity was adjusted to maintain a slight twitching of the midfinger or ring finger(De-Qi response).Patients in group C received electrode plate on the same both acupoints without electrical stimulation.3ml venous blood was collected before the induction of anesthesia,2d after surgery,the serum was isolated and stored at-20℃ for the measurement of serum concentration of high-sensitive troponin T(hs-cTnT)concentration.On 1 day before surgery,1,3 and 5d after surgery,CV200 electrocardiograph was used for 5 min monitoring,R-R interphases were collected after that.The R-R interphases were used to calculate heart rate(HR)and heart rate variability,including: total power(TP),low-frequency(LF)power,high-frequency(HF)power and LF/HF ratio.Results: There were no statistically significant differences between the two groups in gender,age,BMI,ASA classification,number of comorbidity cases,anesthesia duration and operation duration time.There was no significant difference in hs-cTnT level between the two groups before anesthesia induction.Compared with the time before anesthesia induction,the hs-cTnT concentration in 2 groups increased significantly on 2d after surgery(P<0.05).The concentration of hs-cTnT in group T was significantly lower than group C(P<0.05).There were no significant differences in TP,LF,HF and LF/HF between 2 groups before surgery.Compared with the time before surgery,HF decreased significantly,HR increased on 1,3 and 5d after surgery in group C,TP decreased significantly on 1,3d after surgery(P<0.05);HR increased significantly on 1d after surgery in group T(P<0.05).Compared with group C,TP and HF increased significantly,HR decreased significantly on 1d after surgery in group T(P<0.05).There were no significant differences in postoperative cardiac adverse reactions between the two groups.Conclusion: TEAS(disperse-dense waves,4/20Hz)on PC6(Neiguan)and PC4(Ximen)from 30 min before anesthesia to the end of surgery can produce cardioprotective effect in elderly CHD patients undergoing non-cardiac surgery,and the mechanism may be related to the regulation of autonomic nerve function and the enhancement of vagus nerve activity.