经皮穴位电刺激疗法联合丙泊酚复合瑞芬太尼对全身麻醉下行鼻内镜手术患者的影响

Impact of transcutaneous electric acupoint stimulation therapy combined with propofol and remifentanil on patients undergoing nasal endoscopic surgery under general anesthesia

摘要:

目的 探讨经皮穴位电刺激疗法（TEAS）联合丙泊酚复合瑞芬太尼对全身麻醉下行鼻内镜手术患者术野质量、镇痛效果和术后恢复的影响。方法 选取2024年9月－2025年2月该院择期进行全身麻醉下鼻内镜手术的患者94例，随机分为两组，各47例。对照组给予丙泊酚复合瑞芬太尼进行麻醉，TEAS组给予TEAS联合丙泊酚复合瑞芬太尼进行麻醉。比较两组手术相关情况、镇痛效果和术后恢复情况。结果 TEAS组术中出血量明显少于对照组，Boezaart分级量表（BS）评分明显低于对照组，术中瑞芬太尼和丙泊酚累积用量明显少于对照组，差异均有统计学意义（P < 0.05）。术后1和2 d，TEAS组视觉模拟评分法（VAS）评分明显低于对照组，差异均有统计学意义（P < 0.05）。术后1 d，两组活化部分凝血活酶时间（APTT）和血小板计数（PLT）水平明显高于术前，且TEAS组明显高于对照组，两组D-二聚体（D-D）水平明显低于术前，且TEAS组明显低于对照组，差异均有统计学意义（P < 0.05）。术后1和2 d，TEAS组15项恢复质量评分量表（QoR-15）评分明显高于对照组，差异均有统计学意义（P < 0.05）。术后，TEAS组恶心呕吐和头晕头痛发生率明显低于对照组，差异均有统计学意义（P < 0.05）。结论 TEAS联合丙泊酚复合瑞芬太尼能够提高全身麻醉下行鼻内镜手术的术野质量，增强镇痛效果，促进术后恢复。值得应用于临床。

Abstract:

Objective To discuss the impacts of transcutaneous electric acupoint stimulation (TEAS) combined with composite anesthesia of propofol and remifentanil on the surgical field， analgesic effect, and postoperative recovery of patients undergoing nasal endoscopic surgery under general anesthesia.Methods 94 patients who underwent nasal endoscopic surgery under general anesthesia from September 2024 to February 2025 were selected and randomly divided into two groups, with 47 cases in each group. The control group was anesthetized with propofol combined with remifentanil, while the TEAS group was anesthetized with TEAS combined with propofol combined with remifentanil. The surgical-related conditions, analgesic effect and postoperative recovery of the two groups were compared.Results The intraoperative blood loss in the TEAS group was significantly less than that in the control group, the Boezaart Scale (BS) score was significantly lower than that in the control group, and the cumulative dosage of remifentanil and propofol during the operation was significantly less than that in the control group, the differences were statistically significant (P < 0.05). On the 1st and 2nd days after the operation, the visual analogue scale (VAS) scores of the TEAS group were significantly lower than those of the control group, and the differences were statistically significant (P < 0.05). One day after the operation, the levels of activated partial thromboplastin time (APTT) and platelet count (PLT) in both groups were significantly higher than those before the operation, and those in the TEAS group were significantly higher than those in the control group; The levels of D-dimer (D-D) in both groups were significantly lower than those before the operation, and that in the TEAS group was significantly lower than that in the control group, the differences were statistically significant (P < 0.05). On the 1st and 2nd day after the operation, the scores of the 15-item quality of recovery scale (QoR-15) in the TEAS group were significantly higher than those in the control group, and the differences were statistically significant (P < 0.05). After the operation, the incidences of nausea, vomiting, dizziness, and headache in the TEAS group was significantly lower than those in the control group, and the differences were statistically significant (P < 0.05).Conclusion TEAS combined with propofol and remifentanil can improve the surgical field quality of nasal endoscopic surgery under general anesthesia, enhance the analgesic effect and promote postoperative recovery. It is worth applying in clinical practice.