经皮神经电刺激联合胸椎旁神经阻滞对胸腔镜手术术后睡眠质量、疼痛和质量恢复的影响

doi:10.3969/j.issn.2095-378X.2023.03.010

外科研究与新技术 ›› 2023, Vol. 12 ›› Issue (3): 197-202.doi: 10.3969/j.issn.2095-378X.2023.03.010

经皮神经电刺激联合胸椎旁神经阻滞对胸腔镜手术术后睡眠质量、疼痛和质量恢复的影响

李娜¹, 衡垒²

1.徐州新健康老年病医院麻醉科, 江苏徐州 221009;
2.徐州市肿瘤医院麻醉科, 江苏徐州 221009

收稿日期:2023-03-24 出版日期:2023-09-28 发布日期:2023-10-24
通讯作者: 衡垒,电子信箱：348654564@qq.com
作者简介:李娜（1990—）,女,大学本科,主治医师,从事临床麻醉科工作
基金资助:
江苏省徐州市推动科技创新项目（重点研发）（KC19148）; 江苏大学2023年度医教协同创新基金一般项目（JDYY2023047）

Effect of transcutaneous electrical acupoint stimulation combined with thoracic paravertebral block on postoperative sleep quality, pain, and quality of recovery of patients after video-assisted thoracoscopic surgery

LI Na¹, HENG Lei²

1. Department of Anesthesiology,Xuzhou New Healthy Geriatric Hospital, Xuzhou 221009, Jiangsu, China;
2. Department of Anesthesiology, Xuzhou Cancer Hospital, Xuzhou 221009, Jiangsu, China

Received:2023-03-24 Online:2023-09-28 Published:2023-10-24

摘要/Abstract

摘要： 目的探讨经皮穴位电刺激（transcutaneous electrical acupoint stimulation, TEAS）联合胸椎旁神经阻滞（thoracic paravertebral block, TPVB）对胸腔镜手术术后睡眠质量、疼痛和质量恢复的影响。方法选取2022年6月—2023年3月行胸腔镜手术的60位患者作为研究对象,根据随机数字表法将患者分为对照组（C组）、TEAS组（T组）,每组患者30例。T组患者麻醉诱导前30 min于双侧肺俞、内关、神门行TEAS至手术结束。C组患者麻醉诱导前在相同穴位上贴电极片,但是不通电。麻醉诱导前两组患者均行TPVB,注入0.375%的罗哌卡因25 mL。观察并比较两组患者术前24 h（T0）、术后24 h（T1）、术后48 h（T2）、术后7 d（T3）、术后14 d（T4）的睡眠质量,术后24 h恢复质量量表（15-item Quality of Recovery, QoR-15）评分和术后拔管后视觉模拟评分法（visual analogue scale,VAS）评分,术后镇痛泵使用情况,术后恶心、呕吐（PONV）发生情况。结果 T1,T2,T3时间点,T组匹兹堡睡眠质量指数（Pittsburgh sleep quality index, PSQI）明显低于C组,差异有统计学意义（P<0.05）;T组术后24 h QoR-15总分高于C组且差异有统计学意义（P<0.05）;T1,T2,T3时间点T组的术后VAS评分明显低于C组,且差异有统计学意义（P<0.05）。T组镇痛泵按压次数少于C组。另外,T组术后恶心呕吐评分低于C组,差异有统计学意义（P<0.05）。术后其他并发症,两组相比差异无统计学意义（P>0.05）。结论采取TEAS联合TPVB能减轻胸腔镜手术患者术后疼痛,并且改善术后恢复质量。

关键词: 胸椎旁神经阻滞, 经皮穴位电刺激, 胸腔镜手术, 恢复质量, 睡眠质量

Abstract: Objective To observe the effect of transcutaneous electrical acupoint stimulation （TEAS） and thoracic paravertebral block on sleep quality, pain, and quality of recovery after surgery in patients undergoing selective video-assisted thoracoscopic surgery. Methods A total of 60 patients undergoing video-assisted thoracoscopic surgery from June 2022 to March 2023 were selected and divided into the TEAS group or the control group by the random table method. Thirty minutes before anesthesia induction TEAS treatment was performed at Feishu, Neiguan, and Shenmen points bilaterally in the TEAS group until the end of surgery. The control group had the acupuncture electrodes on the same acupuncture point before anesthesia induction without electrical stimulus. The two groups of patients received a TPVB with ropivacaine （0.375%, 25 mL） before anesthesia induction. The visual analog scale （VAS） was used to evaluate pain scores after surgery and Pittsburgh Sleep Quality Index （PSQI） was used for evaluating subjective sleep quality. The PSQI scores were recorded at 24 h before operation （T0）, 24 h （T1）, 48 h （T2）, 7 d （T3）, and 14 d （T4） after operation. 15-item Quality of Recovery scores and VAS scores were also evaluated at 24 h after operation. Postoperative analgesic pump use and postoperative nausea and vomiting （PONV） were also recorded. Results Compared with the control group, the TEAS group showed significantly lower PSQI scores at T1, T2, and T3 （P<0.05）, a higher QoR-15 score at postoperative 24 h （P<0.05）, and lower VAS scores at T1, T2, and T3 （P<0.05）. The frequency of analgesic pump pressing of the TEAS group was lower than that of the control group. In addition, the PONV score of the TEAS group was lower than that of the control group （P<0.05）. There was no difference in other postoperative complications between the two groups （P>0.05）. Conclusion TEAS combined with TPVB can relieve postoperative pain and improve quality of recovery of patients after video-assisted thoracoscopic surgery.

Key words: Thoracic paravertebral block, Transcutaneous electrical acupoint stimulation, Video-assisted thoracoscopic surgery, Quality of recovery, Sleep quality

中图分类号:

R614.2

李娜, 衡垒. 经皮神经电刺激联合胸椎旁神经阻滞对胸腔镜手术术后睡眠质量、疼痛和质量恢复的影响[J]. 外科研究与新技术, 2023, 12(3): 197-202.

LI Na, HENG Lei. Effect of transcutaneous electrical acupoint stimulation combined with thoracic paravertebral block on postoperative sleep quality, pain, and quality of recovery of patients after video-assisted thoracoscopic surgery[J]. Surgical Research and New Technique, 2023, 12(3): 197-202.

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经皮神经电刺激联合胸椎旁神经阻滞对胸腔镜手术术后睡眠质量、疼痛和质量恢复的影响

Effect of transcutaneous electrical acupoint stimulation combined with thoracic paravertebral block on postoperative sleep quality, pain, and quality of recovery of patients after video-assisted thoracoscopic surgery

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