Effects of TEAS on Stress Response During Extubation of General Anesthesia in Elderly Patients
- Conditions
- Stress
- Interventions
- Device: PlaceboDevice: Hwato Electronic Acupuncture Treatment Instrument
- Registration Number
- NCT02533388
- Lead Sponsor
- Shengjing Hospital
- Brief Summary
Elderly patients have an increased risk of stress responses during extubation after general anaesthesia for an elective supratentorial craniotomy. How to decrease the stress responses during extubation after general anaesthesia remains challenging for the anaesthesiologist. In this study, we aimed to investigate whether transcutaneous electrical acupoint stimulation (TEAS) might decrease the stress responses and improve the quality of recovery in the elderly patients who underwent elective supratentorial craniotomy under general anaesthesia.
- Detailed Description
A total of 100 elderly patients scheduled for elective supratentorial craniotomy under propofol-remifentanil total intravenous anaesthesia were randomly divided to either TEAS group (received stimulation at LI4, PC6, LU7, LU5, LI18 and ST9 acupoints, 2/10Hz, 6-15 mA) or Sham group (received no stimulation). The primary outcomes were the haemodynamic parameters and plasma concentrations of epinephrine (E), norepinephrine (NE) and cortisol (Cor). The secondary outcomes were the consumption of remifentanil and propofol, the time from discontinuation of anesthetics to extubation and reorientation, extubation quality score, the quality of postoperative recovery and postoperative complications.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 100
- ASA Ⅱ～Ⅲ
- aged 60-70years
- scheduled for elective supratentorial craniotomy under general anaesthesia
- past or current history of cardiovascular and/or cerebrovascular diseases
- diabetes
- pre-existing liver, lung or kidney dysfunction
- psychiatric disorders
- potentially difficult airway
- previous acupuncture treatment
- infection at the stimulus sites
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Sham stimulation Placebo Sham stimulation only connected to the apparatus, but electronic stimulation was not applied. Electrical acupoint stimulation Hwato Electronic Acupuncture Treatment Instrument Electrical acupoint stimulation at the Hegu (LI4), Neiguan (PC6), Lieque (LU7), Chize (LU5), Futu (LI18) and Renying (ST9) acupoints, Stimulus frequency was an alternate dense-disperse frequency of 2/10 Hz ( 2 Hz for 10 s and 10 Hz for 5 s). The optimal intensity ranged from 6-15 mA, which was adjusted to maintain a slight twitching of the regional muscles according to individual maximum tolerance.
- Primary Outcome Measures
Name Time Method Change in plasma concentrations of epinephrine Before the onset of TEAS,prior to induction, at the end of surgery, immediately after extubation, and 5 and 10 min after extubation plasma concentrations of epinephrine was recorded before the onset of TEAS,prior to induction, at the end of surgery, immediately after extubation, and 5 and 10 min after extubation
Change in mean arterial blood pressure Before the onset of TEAS,prior to induction, at the end of surgery, immediately after extubation, and 5 and 10 min after extubation Mean arterial blood pressure was recorded before the onset of TEAS,prior to induction, at the end of surgery, immediately after extubation, and 5 and 10 min after extubation
Change in heart rate Before the onset of TEAS,prior to induction, at the end of surgery, immediately after extubation, and 5 and 10 min after extubation Heart rate was recorded before the onset of TEAS,prior to induction, at the end of surgery, immediately after extubation, and 5 and 10 min after extubation
Change in cortisol Before the onset of TEAS,prior to induction, at the end of surgery, immediately after extubation, and 5 and 10 min after extubation Cortisol was recorded before the onset of TEAS,prior to induction, at the end of surgery, immediately after extubation, and 5 and 10 min after extubation
Change in Non-invasive arterial blood pressure Before the onset of TEAS,prior to induction, at the end of surgery, immediately after extubation, and 5 and 10 min after extubation Non-invasive arterial blood pressure was recorded before the onset of TEAS,prior to induction, at the end of surgery, immediately after extubation, and 5 and 10 min after extubation
Change in norepinephrine Before the onset of TEAS,prior to induction, at the end of surgery, immediately after extubation, and 5 and 10 min after extubation Norepinephrine was recorded before the onset of TEAS,prior to induction, at the end of surgery, immediately after extubation, and 5 and 10 min after extubation
- Secondary Outcome Measures
Name Time Method The total amount of propofol that used throughout the surgery From discontinuation of anaesthetic drugs to 24 h after surgery Postoperative quality of recovery assessed by Quality of Recovery-40 questionnaire(QoR-40) From discontinuation of anaesthetic drugs to 24 h after surgery the time to extubation,the time to reorientation From discontinuation of anaesthetic drugs to 24 h after surgery The total amount of remifentanil that used throughout the surgery From discontinuation of anaesthetic drugs to 24 h after surgery the quality of extubation was evaluated by a 5-point Extubation Quality Score From discontinuation of anaesthetic drugs to 24 h after surgery Postoperative complications,like cough,agitation,nausea and vomiting From discontinuation of anaesthetic drugs to 24 h after surgery Cough was assessed using a four-point scale；Agitation was evaluated using the Ricker Sedation-Agitation Scale；Nausea was defined as the patient complained of an unpleasant sensation with the urgency to vomit. Vomiting was defined as the forceful expulsion of gastric contents from the patient's mouth.
Trial Locations
- Locations (1)
Shengjing hospital of China medical university
🇨🇳Shenyang, Liaoning, China