【摘要】 目的：观察经皮穴位电刺激辅助全凭静脉麻醉在开腹行直肠癌根治术中对减少丙泊酚和舒芬太尼用量以及术后镇痛的效果。方法：选取中国医科大学附属第一医院2017年12月至2018年12月收治的全身麻醉下开腹行直肠癌根治术的40例患者为研究对象，年龄18～65岁，美国麻醉医师协会（American Society of Anesthesiologists,ASA）分级Ⅰ～Ⅱ级。采用随机数字表法，将其分为电刺激组和对照组（每组20例）。患者均采用全凭静脉麻醉，先予舒芬太尼、丙泊酚、顺式阿曲库铵行麻醉诱导后插入气管导管，靶控输注丙泊酚以维持脑电双频指数为40～60，根据血压和心率水平间断静脉注射舒芬太尼维持镇痛，顺式阿曲库铵维持骨骼肌松弛；仅对电刺激组患者给予经皮穴位电刺激。记录并比较术中丙泊酚和舒芬太尼用量、术后补救性镇痛情况、躁动评分（ramsay score,RS），拔管即刻和术后24 h的视觉模拟评分法（visual analogue scale,VAS）评分，患者对麻醉满意度的评分。结果：电刺激组在舒芬太尼用量、麻醉后监测治疗室（postanesthesia care unit,PACU）内补救性镇痛率、拔管即刻的VAS评分、术后24 h的VAS评分、RS等方面均显著低于对照组，差异均有统计学意义（均P <0.05）；电刺激组患者对麻醉满意度评分高于对照组（P <0.05）；两组术中丙泊酚用量和术后病房24 h内补救镇痛率差异无统计学意义（P> 0.05）。结论：经皮穴位电刺激辅助全凭静脉麻醉应用于开腹行直肠癌根治术中可减少术中舒芬太尼用量和PACU内补救性镇痛率，降低术后RS和VAS评分，提高患者的麻醉满意度。更多还原

【Abstract】 Objective: To observe the effects of the dosage reduction of propofol and sufentanil and the postoperative analgesia while applying intravenous anesthesia combined with transcutaneous electrical acupoint stimulation(TEAS) to radical resection of rectal cancer. Methods: A total of 40 patients scheduled for elective open surgery to radical resection of rectal cancer under general anesthesia in the First Affiliated Hospital of China Medical University from December 2017 to December 2018 were selected as subjects. They were aged 18 ～ 65 with ASA physical status of Ⅰ ～ Ⅱ and randomly divided into 2 groups(n = 20 in each) using a random number table,TEAS group and control group. After anesthesia was induced with propofol, sufentanil, cisatracurium, the endotracheal tube was inserted.Propofol was given by target-controlled infusion to maintain BIS value in the range of 40 ～ 60. Intermittent intravenous sufentanil to maintain analgesia according to the blood pressure and heart rate. Cisatracurium was infused continuously to facilitate muscle relaxation. The intraoperative dosage of propofol and sufentanil, postoperative remedial analgesia,ramsay score(RS), visual analogue scale(VAS) at the time of pull out the endotracheal tube and 24 h after surgery, patient satisfaction score for anesthesia were recorded and compared. Results: In TEAS group, the dosages of sufentanil, the rate of remedial analgesia in PACU, RS, VAS at the time of pull out the endotracheal tube and 24 h after surgery were lower than those of control group(all P < 0.05). Patients’ satisfaction score for anesthesia in TEAS group were higher than control group(P < 0.05). Conclusion: Application of transcutaneous electrical acupoint stimulation combined with intravenous anesthesia to radical resection of rectal cancers can achieve less dosage of intraoperative sufentanil and reduce the rate of remedial analgesia in PACU, reduce RS and VAS, improve patients’ satisfaction with anesthesia.更多还原